ACADEMIC ALLIANCE IN DERMATOLOGY, INC
NPI 1184291106
Dermatology in St Petersburg, FL

Active since June 08, 2021CLIA Certified · 9 labs
3950 3RD ST N STE A, ST PETERSBURG, FL 33703(727) 821-0612(727) 822-5507 Get Directions Write a Review

NPPES record last updated: April 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 21, 2022, Jun 8, 2021 (2 updates tracked since 2021).

About Academic Alliance In Dermatology, Inc NPPES

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

ACADEMIC ALLIANCE IN DERMATOLOGY, INC (NPI 1184291106) is a healthcare organization registered as a dermatology in St Petersburg, Florida and active in the NPI registry since June 2021. The organization holds 9 active CLIA laboratory certificates and lists Angela Peterman, President/owner, as its authorized official.

NPPES Registry Identity

NPI1184291106
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameACADEMIC ALLIANCE IN DERMATOLOGY, INC
Location Address3950 3RD ST N STE ASt Petersburg, FL 33703-6123
Mailing Address5210 Webb RdTampa, FL 33615-4518 · (813) 882-9986 · Fax (813) 882-9849
Fax(727) 822-5507
Organization SubpartYes
Authorized OfficialAngela PetermanPresident/owner · (410) 766-0111
Enumeration DateJune 8, 2021
Last NPPES UpdateApril 21, 20222 updates tracked since enumeration
NPPES CertifiedApril 21, 2022
NPI 1184291106 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

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 ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedDermatology · Pediatric DermatologyTaxonomy 207NP0225X
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X
3950 3RD ST N STE A, St Petersburg, FL 33703

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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA 11

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 10D0985176

Academic Alliance In Dermatology Inc · Tampa, FL
Active · expires Dec 18, 2026
CLIA Number10D0985176
Laboratory TypeIndependent
Certificate Effective DateDecember 19, 2024
Certificate Expiration DateDecember 18, 2026
Laboratory DirectorDr. Iriana Belongie
Laboratory Phone(813) 882-9849
Laboratory LocationAcademic Alliance In Dermatology Inc5210 Webb Rd, Tampa, FL 33615
CLIA data matches this NPI record on: Address Name
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 for Provider-Performed Microscopy Procedures (PPMP) 10D2112715

Academic Alliance In Dermatology Inc · Tampa, FL
Active · expires May 5, 2028
CLIA Number10D2112715
Laboratory TypePhysician Office
Certificate Effective DateMay 6, 2026
Certificate Expiration DateMay 5, 2028
Laboratory DirectorDr. Matthey Zook
Laboratory Phone(813) 882-9986
Laboratory LocationAcademic Alliance In Dermatology Inc4700 N Habana Ave Suite 303, Tampa, FL 33614
CLIA data matches this NPI record on: Name 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.

Certificate of Compliance 10D2056004

Academic Alliance In Dermatology · Clearwater, FL
Active · expires Aug 29, 2027
CLIA Number10D2056004
Laboratory TypePhysician Office
Certificate Effective DateAugust 30, 2025
Certificate Expiration DateAugust 29, 2027
Laboratory DirectorMatthew Zook
Laboratory Phone(813) 882-9986
Laboratory LocationAcademic Alliance In Dermatology915 Chestnut Street Suite 200, Clearwater, FL 33756
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 10D2132625

Academic Alliance In Dermatology Inc · Largo, FL
Active · expires Jul 26, 2027
CLIA Number10D2132625
Laboratory TypePhysician Office
Certificate Effective DateJuly 27, 2025
Certificate Expiration DateJuly 26, 2027
Laboratory DirectorDr. Jack N. Gay
Laboratory Phone(813) 882-9986
Laboratory LocationAcademic Alliance In Dermatology Inc1260 West Bay Dr Building C Suite C, Largo, FL 33770
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 10D1037280

Academic Alliance In Dermatology Inc · Tampa, FL
Active · expires Jul 20, 2027
CLIA Number10D1037280
Laboratory TypePhysician Office
Certificate Effective DateJuly 21, 2025
Certificate Expiration DateJuly 20, 2027
Laboratory DirectorDr. Panayiotis Vasiloudes
Laboratory Phone(813) 882-9986
Laboratory LocationAcademic Alliance In Dermatology Inc4238 West Kennedy Blvd, Tampa, FL 33609
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 for Provider-Performed Microscopy Procedures (PPMP) 10D2205208

Academic Alliance In Dermatology Inc · Saint Petersburg, FL
Active · expires Dec 13, 2026
CLIA Number10D2205208
Laboratory TypePhysician Office
Certificate Effective DateDecember 14, 2024
Certificate Expiration DateDecember 13, 2026
Laboratory DirectorMatthew Zook
Laboratory Phone(727) 821-0612
Laboratory LocationAcademic Alliance In Dermatology Inc3950 3rd N. Ste. A, Saint Petersburg, FL 33703
CLIA data matches this NPI record on: Name 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.

Other Providers at the Same Location NPPES 5

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

Dermatology
3950 3RD ST N STE A
ST PETERSBURG, FL 33703
Physician Assistant
3950 3RD ST N STE A
ST PETERSBURG, FL 33703
Nurse Practitioner
3950 3RD ST N STE A
ST PETERSBURG, FL 33703
Physician Assistant
3950 3RD ST N STE A
ST PETERSBURG, FL 33703
Physician Assistant
3950 3RD ST N STE A
SAINT PETERSBURG, FL 33703

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 Academic Alliance In Dermatology, Inc's NPI number?

The NPI number for Academic Alliance In Dermatology, Inc is 1184291106. It was assigned to this organization in the NPPES registry on June 8, 2021.

Where is Academic Alliance In Dermatology, Inc located?

Academic Alliance In Dermatology, Inc is located at 3950 3rd St N Ste A, St Petersburg, FL 33703. The listed phone number is (727) 821-0612.

What is Academic Alliance In Dermatology, Inc's specialty?

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

Does Academic Alliance In Dermatology, Inc hold CLIA laboratory certificates?

Yes. 9 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 Academic Alliance In Dermatology, Inc accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Academic Alliance In Dermatology, Inc 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 Academic Alliance In Dermatology, Inc was last updated on April 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.