ORLANDO DERMATOLOGY CENTER
NPI 1174078281
Dermatology in Oviedo, FL

Active since August 18, 2016CLIA Certified · 3 labs
7560 RED BUG LAKE RD STE 1014, OVIEDO, FL 32765(407) 706-1770 Get Directions Write a Review

NPPES record last updated: July 12, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 12, 2024, Feb 6, 2024, Aug 18, 2016 (3 updates tracked since 2016).

About Orlando Dermatology Center NPPES

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

ORLANDO DERMATOLOGY CENTER (NPI 1174078281) is a healthcare organization registered as a dermatology in Oviedo, Florida and active in the NPI registry since August 2016. The organization holds 3 active CLIA laboratory certificates, maintains 3 additional practice locations, and lists Vitaly Blatnoy, Owner, as its authorized official.

NPPES Registry Identity

NPI1174078281
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDERMATOLOGY AND SKIN CANCER SURGERY CENTER, LLC
Location Address7560 RED BUG LAKE RD STE 1014Oviedo, FL 32765-6591
Mailing Address7560 Red Bug Lake Rd Ste 1014Oviedo, FL 32765-6591 · (407) 706-1770 · Fax (407) 650-3455
Organization SubpartNo
Authorized OfficialVitaly BlatnoyOwner · (407) 706-1770
Enumeration DateAugust 18, 2016
Last NPPES UpdateJuly 12, 20243 updates tracked since enumeration
NPPES CertifiedJuly 12, 2024
✔ NPI 1174078281 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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.
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
7560 RED BUG LAKE RD STE 1014, Oviedo, FL 32765

Other Names 1

Doing Business AsOrlando Dermatology Center

Secondary Practice Locations 3

Location 1731 Stirling Center PlLake Mary, FL 32746-5209 · Phone (407) 436-7375
Location 24970 S US Highway 17/92Casselberry, FL 32707-3888 · Phone (407) 635-8012
Location 3422 S Alafaya Trl Ste 26Orlando, FL 32828-8984 · Phone (407) 538-3855

Other Identifiers 1

Medicaid001633600FL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Orlando Dermatology Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

10

Medicare enrollment records show 10 clinicians reassign Medicare billing to Orlando Dermatology Center, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 5 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 4

Nurse Practitioner5
Dermatology3
Obstetrics/Gynecology1
Otolaryngology1

Clinicians, nearest first (10)

Dermatology
NPI 1669462123
7560 RED BUG LAKE RD STE 1014
Oviedo, FL 32765
(407) 706-1770
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1821475724
7560 RED BUG LAKE RD STE 1014
Oviedo, FL 32765
(407) 706-1770
✔ PECOS✔ Accepts MedicareSame address
Otolaryngology
NPI 1083639561
7560 RED BUG LAKE RD STE 1014
Oviedo, FL 32765
(407) 706-1770
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1952188633
4970 S US HIGHWAY 17/92
Casselberry, FL 32707
(407) 635-8012
✔ PECOS✔ Accepts Medicare5.9 mi
Nurse Practitioner
NPI 1427224237
422 S ALAFAYA TRL STE 26
Orlando, FL 32828
(407) 538-3855
✔ PECOS✔ Accepts Medicare7.1 mi
Nurse Practitioner
NPI 1235895574
731 STIRLING CENTER PL UNIT 1931
Lake Mary, FL 32746
(407) 436-7375
✔ PECOS11 mi
Obstetrics/Gynecology
NPI 1083778393
731 STIRLING CENTER PL UNIT 1931
Lake Mary, FL 32746
(407) 436-7375
✔ PECOS11 mi
Dermatology
NPI 1003313735
731 STIRLING CENTER PL UNIT 1931
Lake Mary, FL 32746
(407) 436-7375
✔ PECOS✔ Accepts Medicare11 mi
Nurse Practitioner
NPI 1225352610
731 STIRLING CENTER PL UNIT 1931
Lake Mary, FL 32746
(407) 436-7375
✔ PECOS✔ Accepts Medicare11 mi
Dermatology
NPI 1700997988
1998 HENDERSONVILLE RD STE 53
Asheville, NC 28803
(828) 585-5489
✔ PECOS477 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 3

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 Accreditation 10D2164056

Dermatology And Skin Cancer Surgery Center LLC · Lake Mary, FL
Active · expires Sep 17, 2028
CLIA Number10D2164056
Laboratory TypePhysician Office
Certificate Effective DateSeptember 18, 2026
Certificate Expiration DateSeptember 17, 2028
Laboratory DirectorDr. Vitaly Blatnoy
Laboratory Phone(407) 436-7375
Laboratory LocationDermatology And Skin Cancer Surgery Center LLC731 Stirling Center Place #1931, Lake Mary, FL 32746
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 10D2300847

Dermatology And Skin Cancer Surgery Center LLC · Casselberry, FL
Active · expires Mar 17, 2028
CLIA Number10D2300847
Laboratory TypePhysician Office
Certificate Effective DateMarch 18, 2026
Certificate Expiration DateMarch 17, 2028
Laboratory DirectorVitaly Blatnoy
Laboratory Phone(407) 706-1770
Laboratory LocationDermatology And Skin Cancer Surgery Center LLC4970 S Us 17-92, Casselberry, FL 32707
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 10D2102880

Dermatology And Skin Cancer Surgery Center LLC · Orlando, FL
Active · expires Jan 18, 2028
CLIA Number10D2102880
Laboratory TypePhysician Office
Certificate Effective DateJanuary 19, 2026
Certificate Expiration DateJanuary 18, 2028
Laboratory DirectorDr. Vitaly Blatnoy
Laboratory Phone(407) 538-3855
Laboratory LocationDermatology And Skin Cancer Surgery Center LLC422 S Alafaya Str #26, Orlando, FL 32828
CLIA data matches this NPI record on: Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

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 Dermatology And Skin Cancer Surgery Center, LLC's NPI number?

The NPI number for Dermatology And Skin Cancer Surgery Center, LLC is 1174078281. It was assigned to this organization in the NPPES registry on August 18, 2016. The provider is doing business as Orlando Dermatology Center.

Where is Dermatology And Skin Cancer Surgery Center, LLC located?

Dermatology And Skin Cancer Surgery Center, LLC is located at 7560 Red Bug Lake Rd Ste 1014, Oviedo, FL 32765. The listed phone number is (407) 706-1770.

What is Dermatology And Skin Cancer Surgery Center, LLC's specialty?

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

Is Dermatology And Skin Cancer Surgery Center, LLC enrolled in Medicare?

Yes. Dermatology And Skin Cancer Surgery Center, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dermatology And Skin Cancer Surgery Center, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 4 Medicare specialties reassign their Medicare billing to Dermatology And Skin Cancer Surgery Center, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (5), Dermatology (3) and Obstetrics/Gynecology (1). Of these, 3 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Dermatology And Skin Cancer Surgery Center, LLC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Dermatology And Skin Cancer Surgery Center, LLC accept?

Health plans from Ambetter Health, Ambetter of Alabama, AvMed, Cigna HealthCare of Florida, Inc. and Cigna Healthcare and 2 other insurers list Dermatology And Skin Cancer Surgery Center, 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 Dermatology And Skin Cancer Surgery Center, LLC was last updated on July 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.