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

Sun State Dermatology, LLC

Organization Dermatology Physician · NPI 1093496432

Sun State Dermatology, LLC is a Dermatology Physician in Maitland, 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

430 Lake Howell Rd
Maitland, FL 32751-5907
Phone: (407) 636-3113
Fax: (407) 636-3133
Show map & directions

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

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1093496432
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nathoo Rajiv — Practice Owner · (407) 636-3113
NPI enumeratedJuly 28, 2023
Last updated in NPPESJanuary 6, 2024
Certification dateJanuary 6, 2024
Mailing address430 Lake Howell Rd, Maitland, FL 32751-5907

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