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PALM BAY DERMATOLOGY
NPI 1073577136
Dermatology - MOHS-Micrographic Surgery in Palm Bay, FL

Active since April 14, 2006CLIA Certified · 3 labs
5070 MINTON RD NW, SUITE 5, PALM BAY, FL 32907(321) 768-1600(321) 768-6418 Get Directions Write a Review

NPPES record last updated: November 10, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Palm Bay Dermatology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PALM BAY DERMATOLOGY (NPI 1073577136) is a healthcare organization registered as a mohs-micrographic surgery in Palm Bay, Florida and active in the NPI registry since April 2006. The organization holds 3 active CLIA laboratory certificates and lists Ruben Moreno, President, as its authorized official.

NPPES Registry Identity

NPI1073577136
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameFLORIDA DERMATOLOGY ASSOCIATES INC
Location Address5070 MINTON RD NW, SUITE 5Palm Bay, FL 32907-1157
Mailing Address5070 Minton Rd Nw, Suite 3aPalm Bay, FL 32907-1157 · (321) 768-1600 · Fax (321) 799-4903
Phone(321) 768-1600
Fax(321) 768-6418
Organization SubpartNo
Authorized OfficialRuben MorenoPresident · (321) 768-1600
Enumeration DateApril 14, 2006
Last NPPES UpdateNovember 10, 2023
NPPES CertifiedNovember 10, 2023
✔ NPI 1073577136 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
License✔ Licensed in FL · ME51282
Definition

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

5070 MINTON RD NW, Palm Bay, FL 32907
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Other Names 1

Doing Business AsPalm Bay Dermatology

Other Identifiers 3

Other070002166AFL · Railroad Medicare
Other94928FL · Bcbs
Other169940FL · Wellcare

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 10D0938368

Palm Bay Dermatology · Palm Bay, FL
Active · expires Apr 1, 2028
CLIA Number10D0938368
Laboratory TypePhysician Office
Certificate Effective DateApril 2, 2026
Certificate Expiration DateApril 1, 2028
Laboratory DirectorRuben A. Moreno
Laboratory Phone(321) 768-1600
Laboratory LocationPalm Bay Dermatology5070 NW Minton Rd Ste 2, Palm Bay, FL 32907
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 10D0939580

Florida Dermatology Associates Inc · Cocoa Beach, FL
Active · expires Feb 29, 2028
CLIA Number10D0939580
Laboratory TypePhysician Office
Certificate Effective DateMarch 1, 2026
Certificate Expiration DateFebruary 29, 2028
Laboratory DirectorRuben A. Moreno
Laboratory Phone(321) 768-1600
Laboratory LocationFlorida Dermatology Associates Inc80 Woodland Ave, Cocoa Beach, FL 32931
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 10D2092369

Florida Dermatology Associates Inc Dba Suntree Dermatology · Melbourne, FL
Active · expires Apr 27, 2027
CLIA Number10D2092369
Laboratory TypePhysician Office
Certificate Effective DateApril 28, 2025
Certificate Expiration DateApril 27, 2027
Laboratory DirectorRuben A. Moreno
Laboratory Phone(321) 768-1600
Laboratory LocationFlorida Dermatology Associates Inc Dba Suntree Dermatology7640 N Wickham Rd, Melbourne, FL 32940
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 10D2267288

Florida Medical Associates LLC Dba Vipcare · Palm Bay, FL
Active · expires Aug 22, 2026
CLIA Number10D2267288
Laboratory TypePhysician Office
Certificate Effective DateAugust 23, 2024
Certificate Expiration DateAugust 22, 2026
Laboratory DirectorSangeeta Hans
Laboratory Phone(813) 450-4609
Laboratory LocationFlorida Medical Associates LLC Dba Vipcare590 Malabar Rd Ste 1, Palm Bay, FL 32907
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARIA L FORTINGTON PAC
Physician Assistant
5070 MINTON RD NW, SUITE 5
PALM BAY, FL 32907
Brevard County (321) 768-1600
FRANK G LEE M.D.
Dermatology
5070 MINTON RD NW, SUITE 5
PALM BAY, FL 32907
Brevard County (321) 768-1600
DR. ROBERT MICHAEL TAYLOR M.D.
Dermatology
5070 MINTON RD NW, STE 5
PALM BAY, FL 32907
Brevard County (941) 484-1510
DR. RUBEN ANTENOR MORENO MD
Dermatology (MOHS-Micrographic Surgery)
5070 MINTON RD NW, SUITE 5
PALM BAY, FL 32907
Brevard County (321) 768-1600

Frequently Asked Questions

What is FLORIDA DERMATOLOGY ASSOCIATES INC's NPI number?

The NPI number assigned to this healthcare provider is 1073577136, enumerated as an "organization" on April 14, 2006.

Where is the provider located?

The provider is located at 5070 MINTON RD NW SUITE 5 PALM BAY, FL 32907 and the phone number is (321) 768-1600.

What is the provider's specialty?

Dermatology with taxonomy code 207ND0101X and a focus in MOHS-Micrographic Surgery.

What insurance does FLORIDA DERMATOLOGY ASSOCIATES INC accept?

The provider might be accepting Accepts: Ambetter from Superior HealthPlan, Ambetter. Please consult your insurance carrier or call the provider to verify.