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

Orlando Dermatology Clinic LLC

Organization Dermatology Physician · NPI 1609467109

Orlando Dermatology Clinic LLC is a Dermatology Physician in Kissimmee, Florida. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
3
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

2970 Loopdale Ln
Kissimmee, FL 34741-7658
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
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X
Procedural Dermatology Physician Taxonomy 207NS0135X

Record details

NPI number1609467109
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tarek Shaath — Owner · (785) 760-6740
NPI enumeratedJanuary 28, 2021
Last updated in NPPESNovember 3, 2022
Certification dateNovember 3, 2022
Mailing address1040 Lake Sumter Lndg, The Villages, FL 32162-2697

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