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

Academic Alliance in Dermatology, PLLC

Organization Dermatology Physician · NPI 1184291106

Academic Alliance in Dermatology, PLLC provides Dermatology Physician services in St Petersburg, Florida. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
4
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3950 3rd St N Ste A
St Petersburg, FL 33703-6123
Phone: (727) 821-0612
Fax: (727) 822-5507
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X
Pediatric Dermatology Physician Taxonomy 207NP0225X
Procedural Dermatology Physician Taxonomy 207NS0135X

Record details

NPI number1184291106
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationAcademic Alliance in Dermatology, PLLC
Authorized official Nicole Proffitt — Director Of Enrollment & Credential · (804) 869-6269
NPI enumeratedJune 8, 2021
Last updated in NPPESSeptember 14, 2026
Certification dateSeptember 14, 2026
Mailing addressPo Box 23329, New York, NY 10087-3329

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