Advanced Dermatology and Cosmetic Sur – Dermatology Physician, NPI 1619135183

Advanced Dermatology and Cosmetic Sur is a healthcare provider. based in Maitland, Florida. specializing in Dermatology Physician. The NPI Number for Advanced Dermatology and Cosmetic Sur is 1619135183

Main info

Organization
Name
Advanced Dermatology and Cosmetic Sur
NPI
1619135183
Phone
(407) 875-2080
Address
2600 LAKE LUCIEN DR
Authorized Official
NEFRITA LOGAN PRO SER REP
Enumeration Date
30 May 2008
Last Update Date
30 May 2008
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness80
Years active:18State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for Advanced Dermatology and Cosmetic Sur

  • 2600, Lake Lucien Drive, Maitland, Orange County, Florida, 32751, United States

    SUITE 180

    MAITLAND, FL 327517233

    Phone: (407) 875-2080

    Fax: (407) 875-0518

    Type: Mailing

  • 3500, Northeast 5th Avenue, Pompano Beach, Broward County, Florida, 33064, United States

    POMPANO BEACH, FL 330644445

    Phone: (954) 783-2323

    Fax: (954) 783-2321

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32751)

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Frequently asked questions

How is Advanced Dermatology and Cosmetic Sur identified in CMS data?
CMS-hosted NPPES data lists Advanced Dermatology and Cosmetic Sur with NPI 1619135183.
Does CMS list Advanced Dermatology and Cosmetic Sur as active?
Yes — Advanced Dermatology and Cosmetic Sur is active in the NPI listing used on this page.
What healthcare role does Advanced Dermatology and Cosmetic Sur hold?
Scheduling teams often label Advanced Dermatology and Cosmetic Sur under Dermatology Physician. Clinical services aligned with this taxonomy classification.
Where is Advanced Dermatology and Cosmetic Sur based?
Advanced Dermatology and Cosmetic Sur is tied to Maitland, Florida in the data we show; additional addresses may exist on the full record.
Why does Advanced Dermatology and Cosmetic Sur have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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