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

Orlando Dermatology Clinic, LLC

Organization Dermatology Physician · NPI 1043900947

Orlando Dermatology Clinic, LLC is a Dermatology Physician in Orange City, Florida. Registered with an NPI since 2023.

In the registry since
2023
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

2548 S Volusia Ave
Orange City, FL 32763-9124
Phone: (352) 218-3211
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1043900947
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tarek Shaath — Owner · (352) 218-3211
NPI enumeratedMay 12, 2023
Last updated in NPPESNovember 24, 2023
Certification dateNovember 24, 2023
Mailing address1040 Lake Sumter Lndg, The Villages, FL 32162-2697

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