Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Innovative Dermatology and Mohs Surgery LLC

Organization Dermatology Physician · NPI 1487049722

Innovative Dermatology and Mohs Surgery LLC provides Dermatology Physician services in Lehigh Acres, Florida. Licensed in Florida. Registered with an NPI since 2015.

Licensed in
FL
In the registry since
2015
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3507 Lee Blvd Ste 107
Lehigh Acres, FL 33971-1318 Not confirmed with CMS for 11 years — call before visiting
Phone: (239) 368-8071
Fax: (239) 368-8074
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence ME96589 (FL)

Record details

NPI number1487049722
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrew Kontos — Owner · (239) 368-8071
NPI enumeratedApril 3, 2015
Last updated in NPPESApril 3, 2015
Mailing address3507 Lee Blvd, Ste 107, Lehigh Acres, FL 33971-1318

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