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

Fuller Dermatology LLC

Organization Medical Specialty Clinic/Center · NPI 1083159529

Fuller Dermatology LLC is a Medical Specialty Clinic/Center in South Pasadena, Florida. Licensed in Florida. Registered with an NPI since 2016.

Licensed in
FL
In the registry since
2016
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1609 Pasadena Ave S Ste 4C
South Pasadena, FL 33707
Phone: (727) 347-7524
Show map & directions

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

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X · Licence ME99153 (FL)

Record details

NPI number1083159529
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bruce Fuller — Owner · (727) 347-7524
NPI enumeratedDecember 19, 2016
Last updated in NPPESAugust 29, 2018
Mailing address1609 Pasadena Ave S Ste 4c, South Pasadena, FL 33707-4564