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

Countryside Dermatology and Laser Center Inc

Organization Dermatology Physician · NPI 1194914978

Countryside Dermatology and Laser Center Inc is a Dermatology Physician in Clearwater, Florida. Licensed in Florida. Registered with an NPI since 2007.

Licensed in
FL
In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2467 Enterprise Rd Ste A
Clearwater, FL 33763-1724
Phone: (727) 791-1411
Fax: (727) 791-1419
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 46341 (FL)

Record details

NPI number1194914978
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Susan Roper — Owner · (727) 791-1411
NPI enumeratedOctober 17, 2007
Last updated in NPPESOctober 17, 2007
Mailing address2467 Enterprise Rd, Suite A, Clearwater, FL 33763-1724

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