LUMINARY DERMATOLOGY OF MIAMI, LLC
NPI 1114769767
Dermatology - MOHS-Micrographic Surgery in Miami, FL

Q: What is Luminary Dermatology Of Miami, LLC's NPI number?

The NPI number for Luminary Dermatology Of Miami, LLC is 1114769767. It was assigned to this organization in the NPPES registry on June 12, 2024. The provider is doing business as Luminary Dermatology, PA.

Q: What is Luminary Dermatology Of Miami, LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Active since June 12, 2024CLIA Certified · 5 labs

8740 N KENDALL DR STE 101, MIAMI, FL 33176(305) 661-8978(941) 296-8501 Get Directions Write a Review

NPPES record last updated: June 12, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Luminary Dermatology Of Miami, Llc NPPES

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

LUMINARY DERMATOLOGY OF MIAMI, LLC (NPI 1114769767), doing business as Luminary Dermatology, Pa, is a healthcare organization registered as a mohs-micrographic surgery in Miami, Florida and active in the NPI registry since June 2024. The organization holds 5 active CLIA laboratory certificates, maintains a secondary practice location in Homestead, and lists Jessica Phillips, Ceo, as its authorized official.

NPPES Registry Identity

NPI1114769767

Entity TypeOrganization

Primary Taxonomy207ND0101X

Legal Business NameLUMINARY DERMATOLOGY OF MIAMI, LLC

Location Address8740 N KENDALL DR STE 101Miami, FL 33176-2209

Mailing Address4411 Bee Ridge Rd # 309Sarasota, FL 34233-2514 · (941) 926-6553 · Fax (941) 296-8501

Phone(305) 661-8978

Fax(941) 296-8501

Organization SubpartNo

Authorized OfficialJessica PhillipsCeo · (941) 926-6553

Enumeration DateJune 12, 2024

NPPES CertifiedJune 12, 2024

✔ NPI 1114769767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207ND0101X

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.

8740 N KENDALL DR STE 101, Miami, FL 33176

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Other Names 1

Doing Business AsLuminary Dermatology, Pa

Secondary Practice Location 1

Location 1925 NE 30th Ter Ste 308Homestead, FL 33033-7614 · Phone (786) 670-9799 · Fax (941) 296-8501

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 5

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 10D2251108

Luminary Dermatology Of Miami LLC · Miami, FL

Active · expires Dec 4, 2026

CLIA Number10D2251108

Laboratory TypePhysician Office

Certificate Effective DateDecember 5, 2024

Certificate Expiration DateDecember 4, 2026

Laboratory DirectorCary Dunn

Laboratory Phone(941) 926-6553

Laboratory LocationLuminary Dermatology Of Miami LLC8740 N Kendall Drive Suite 101, Miami, FL 33176

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.

Certificate of Compliance 10D2174138

Luminary Dermatology P.A. · Bradenton, FL

Active · expires May 20, 2028

CLIA Number10D2174138

Laboratory TypePhysician Office

Certificate Effective DateMay 21, 2026

Certificate Expiration DateMay 20, 2028

Laboratory DirectorMichael G. Foss

Laboratory Phone(941) 926-6553

Laboratory LocationLuminary Dermatology P.A.2101 61st St West, Bradenton, FL 34209

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 10D2228499

Luminary Dermatology Of Miami LLC · Homestead, FL

Active · expires Apr 24, 2028

CLIA Number10D2228499

Laboratory TypePhysician Office

Certificate Effective DateApril 25, 2026

Certificate Expiration DateApril 24, 2028

Laboratory DirectorCary L. Dunn

Laboratory Phone(941) 926-6553

Laboratory LocationLuminary Dermatology Of Miami LLC925 NE 30th Terrace Suite 308, Homestead, FL 33033

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 10D2213196

Luminary Dermatology PA · North Port, FL

Active · expires Nov 4, 2027

CLIA Number10D2213196

Laboratory TypePhysician Office

Certificate Effective DateNovember 5, 2025

Certificate Expiration DateNovember 4, 2027

Laboratory DirectorMichael G. Foss

Laboratory Phone(941) 926-6553

Laboratory LocationLuminary Dermatology PA3105 Bobcat Villiage Center Rd, North Port, FL 34288

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 10D2213205

Luminary Dermatology PA · Sarasota, FL

Active · expires Aug 15, 2027

CLIA Number10D2213205

Laboratory TypePhysician Office

Certificate Effective DateAugust 16, 2025

Certificate Expiration DateAugust 15, 2027

Laboratory DirectorMichael G. Foss

Laboratory Phone(941) 926-6553

Laboratory LocationLuminary Dermatology PA2032 Hawthorne St, Sarasota, FL 34239

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.

Other Providers at the Same Location NPPES 8

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

DR. PHYLLIS SKOLNIK M.D.

Dermatology (Procedural Dermatology)