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

Innovative Dermatology and Mohs Surgery LLC

Organization Dermatology Physician · NPI 1487049722

Innovative Dermatology and Mohs Surgery LLC is a Dermatology Physician in Lehigh Acres, Florida. Licensed in Florida. Registered with an NPI since 2015.

Licensed in
FL
In the registry since
2015
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

3507 Lee Blvd Ste 107
Lehigh Acres, FL 33971-1318
Phone: (239) 368-8071
Fax: (239) 368-8074
Show map & directions

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

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence ME96589 (FL)

Record details

NPI number1487049722
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrew Kontos — Owner · (239) 368-8071
NPI enumeratedApril 3, 2015
Last updated in NPPESApril 3, 2015
Mailing address3507 Lee Blvd, Ste 107, Lehigh Acres, FL 33971-1318

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