SUN STATE DERMATOLOGY, LLC
NPI 1093496432
Dermatology in Maitland, FL

Active since July 28, 2023CLIA 10D2288487 · Certificate of Compliance
430 LAKE HOWELL RD, MAITLAND, FL 32751(407) 636-3113(407) 636-3133 Get Directions Write a Review

NPPES record last updated: January 6, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 6, 2024, Oct 30, 2023, Jul 28, 2023 (3 updates tracked since 2023).

About Sun State Dermatology, Llc NPPES

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

SUN STATE DERMATOLOGY, LLC (NPI 1093496432) is a healthcare organization registered as a dermatology in Maitland, Florida and active in the NPI registry since July 2023. The organization holds a CLIA Certificate of Compliance certificate valid through December 22, 2027 and lists Nathoo K Rajiv, Practice Owner, as its authorized official.

NPPES Registry Identity

NPI1093496432
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSUN STATE DERMATOLOGY, LLC
Location Address430 LAKE HOWELL RDMaitland, FL 32751-5907
Mailing Address430 Lake Howell RdMaitland, FL 32751-5907 · (407) 636-3113 · Fax (407) 636-3133
Fax(407) 636-3133
Organization SubpartNo
Authorized OfficialNathoo K RajivPractice Owner · (407) 636-3113
Enumeration DateJuly 28, 2023
Last NPPES UpdateJanuary 6, 20243 updates tracked since enumeration
NPPES CertifiedJanuary 6, 2024
NPI 1093496432 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

430 LAKE HOWELL RD, Maitland, FL 32751

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

CLIA Laboratory Certificates CMS CLIA

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 10D2288487

Sun State Dermatology LLC · Maitland, FL
Active · expires Dec 22, 2027
CLIA Number10D2288487
Laboratory TypePhysician Office
Certificate Effective DateDecember 23, 2025
Certificate Expiration DateDecember 22, 2027
Laboratory DirectorRajiv Kiran Nathoo
Laboratory Phone(407) 636-3113
Laboratory LocationSun State Dermatology LLC430 Lake Howell Rd, Maitland, FL 32751
CLIA data matches this NPI record on: Address 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.

Other Providers at the Same Location NPPES 6

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

Chiropractor
430 LAKE HOWELL RD
MAITLAND, FL 32751
Chiropractor
430 LAKE HOWELL RD
MAITLAND, FL 32751
Chiropractor
430 LAKE HOWELL RD
MAITLAND, FL 32751
Chiropractor
430 LAKE HOWELL RD
MAITLAND, FL 32751
Dermatology
430 LAKE HOWELL RD
MAITLAND, FL 32751
Physician Assistant (Medical)
430 LAKE HOWELL RD
MAITLAND, FL 32751

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sun State Dermatology, LLC's NPI number?

The NPI number for Sun State Dermatology, LLC is 1093496432. It was assigned to this organization in the NPPES registry on July 28, 2023.

Where is Sun State Dermatology, LLC located?

Sun State Dermatology, LLC is located at 430 Lake Howell Rd, Maitland, FL 32751. The listed phone number is (407) 636-3113.

What is Sun State Dermatology, LLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Sun State Dermatology, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 10D2288487) is associated with this NPI, valid through December 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sun State Dermatology, LLC accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Molina Healthcare and Wellpoint list Sun State Dermatology, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sun State Dermatology, LLC was last updated on January 6, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.