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

Galt Dermatology & Concierge Medicine PA

Organization Specialist · NPI 1780964460

Galt Dermatology & Concierge Medicine PA is a Specialist in Fort Lauderdale, Florida. Licensed in Florida. Registered with an NPI since 2011.

Licensed in
FL
In the registry since
2011
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

800 E Broward Blvd Ste 103
Fort Lauderdale, FL 33301-2008
Phone: (954) 463-5406
Fax: (954) 522-2456
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence ME36538 (FL)

Record details

NPI number1780964460
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Miguel Villacorta — President · (954) 463-5406
Other names Galt Dermatology
NPI enumeratedAugust 25, 2011
Last updated in NPPESFebruary 28, 2025
Certification dateFebruary 28, 2025
Mailing address800 E Broward Blvd, Suite 103, Fort Lauderdale, FL 33301-2008

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