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PORTER PREMIER DERMATOLOGY AND SURGERY CENTER, PLLC
NPI 1104152495
Dermatology in Melbourne, FL

Active since October 22, 2009CLIA 10D2010287 · Microscopy
1515 W NASA BLVD STE 101, MELBOURNE, FL 32901(321) 308-0659(321) 309-2881 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 17, 2018, Oct 26, 2017 (2 updates tracked since 2017).

About Porter Premier Dermatology And Surgery Center, Pllc NPPES

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

PORTER PREMIER DERMATOLOGY AND SURGERY CENTER, PLLC (NPI 1104152495) is a healthcare organization registered as a dermatology in Melbourne, Florida and active in the NPI registry since October 2009. The organization holds a CLIA Microscopy certificate valid through December 29, 2027, maintains 2 additional practice locations, and lists Anthony Jerome Porter, Owner, as its authorized official.

NPPES Registry Identity

NPI1104152495
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NamePORTER PREMIER DERMATOLOGY AND SURGERY CENTER, PLLC
Location Address1515 W NASA BLVD STE 101Melbourne, FL 32901-2605
Mailing Address1515 W Nasa Blvd Ste 101Melbourne, FL 32901-2605 · (321) 308-0659 · Fax (321) 309-2881
Phone(321) 308-0659
Fax(321) 309-2881
Organization SubpartNo
Authorized OfficialAnthony Jerome PorterOwner · (321) 308-0659
Enumeration DateOctober 22, 2009
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
✔ NPI 1104152495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in FL · ME96233
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.
1515 W NASA BLVD STE 101, Melbourne, FL 32901
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Secondary Practice Locations 2

Location 11344 S Apollo Blvd Ste 300Melbourne, FL 32901-3183 · Phone (321) 308-0659 · Fax (321) 309-2881
Location 26032 Farcenda Pl Ste 102Melbourne, FL 32940-7341 · Phone (321) 608-8160 · Fax (321) 622-6818

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

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 for Provider-Performed Microscopy Procedures (PPMP) 10D2010287

Porter Premier Dermatology & Surgery Center · Melbourne, FL
Active · expires Dec 29, 2027
CLIA Number10D2010287
Laboratory TypePhysician Office
Certificate Effective DateDecember 30, 2025
Certificate Expiration DateDecember 29, 2027
Laboratory DirectorAnthony J. Porter
Laboratory Phone(321) 308-0659
Laboratory LocationPorter Premier Dermatology & Surgery Center1515 W Nasa Blvd Ste 101, Melbourne, FL 32901
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Porter Premier Dermatology And Surgery Center, PLLC's NPI number?

The NPI number for Porter Premier Dermatology And Surgery Center, PLLC is 1104152495. It was assigned to this organization in the NPPES registry on October 22, 2009.

Where is Porter Premier Dermatology And Surgery Center, PLLC located?

Porter Premier Dermatology And Surgery Center, PLLC is located at 1515 W Nasa Blvd Ste 101, Melbourne, FL 32901. The listed phone number is (321) 308-0659.

What is Porter Premier Dermatology And Surgery Center, PLLC's specialty?

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

Does Porter Premier Dermatology And Surgery Center, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 10D2010287) is associated with this NPI, valid through December 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Porter Premier Dermatology And Surgery Center, PLLC was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.