Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Bellavista Dermatology Group LLC

Organization Dermatology Physician · NPI 1801379409

Bellavista Dermatology Group LLC is a Dermatology Physician in Jacksonville, Florida. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
6
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

3636 University Blvd S Unit B2
Jacksonville, FL 32216
Phone: (904) 297-1415
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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
Dermatopathology Physician Taxonomy 207ND0900X
Clinical & Laboratory Dermatological Immunology Physician Taxonomy 207NI0002X
Pediatric Dermatology Physician Taxonomy 207NP0225X
Procedural Dermatology Physician Taxonomy 207NS0135X

Record details

NPI number1801379409
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Rigel Martinez — Owner · (904) 297-1415
Other names Bellavista Dermatology; Bellavista Dermatology
NPI enumeratedSeptember 10, 2018
Last updated in NPPESSeptember 10, 2018
Mailing address3636 University Blvd S, Unit B2, Jacksonville, FL 32216

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