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

Shadetree Dermatology LLC

Organization Dermatology Physician · NPI 1366297376

Shadetree Dermatology LLC is a Dermatology Physician in Cocoa Beach, Florida. Works from 2 locations. Registered with an NPI since 2024.

In the registry since
2024
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

105 S Banana River Blvd Fl 2
Cocoa Beach, FL 32931-5041
Phone: (321) 200-0346
Show map & directions

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

Additional practice locations (1)

  • 389 Commerce Pkwy Ste 160, Rockledge, FL 32955-4202 — (321) 200-0346

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1366297376
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Vanessa Johnson — Dermatologist (Physician) · (321) 200-0346
NPI enumeratedApril 22, 2024
Last updated in NPPESMarch 4, 2026
Certification dateMarch 4, 2026
Mailing address105 S Banana River Blvd Fl 2, Cocoa Beach, FL 32931-5041

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