1. Home
  2. Directory
  3. Florida
  4. St Petersburg
  5. Dermatology
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

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

Active since June 08, 2021CLIA Certified · 5 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: September 14, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 14, 2026, Apr 21, 2022, Jun 8, 2021 (3 updates tracked since 2021).

About Academic Alliance In Dermatology, Pllc NPPES

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

ACADEMIC ALLIANCE IN DERMATOLOGY, PLLC (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 5 active CLIA laboratory certificates and lists Nicole Proffitt, Director Of Enrollment & Credential, as its authorized official.

NPPES Registry Identity

NPI1184291106
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameACADEMIC ALLIANCE IN DERMATOLOGY, PLLC
Location Address3950 3RD ST N STE ASt Petersburg, FL 33703-6123
Mailing AddressPo Box 23329New York, NY 10087-3329 · Fax (410) 883-0876
Phone(727) 821-0612
Fax(727) 822-5507
Organization SubpartYes
Authorized OfficialNicole ProffittDirector Of Enrollment & Credential · (804) 869-6269
Enumeration DateJune 8, 2021
Last NPPES UpdateSeptember 14, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 14, 2026
✔ 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
Open in Google Maps ↗

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

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA 7

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) 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.

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
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 Waiver 10D2255822

Academic Alliance In Dermatology, Inc · Tampa, FL
Active · expires Mar 16, 2028
CLIA Number10D2255822
Laboratory TypePhysician Office
Certificate Effective DateMarch 17, 2026
Certificate Expiration DateMarch 16, 2028
Laboratory DirectorIriana Belongie
Laboratory Phone(813) 882-9849
Laboratory LocationAcademic Alliance In Dermatology, Inc6331 Memorial Hwy, Tampa, FL 33615
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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: 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) 10D2205051

Academic Alliance In Dermatology Inc · Tampa, FL
Active · expires Dec 10, 2026
CLIA Number10D2205051
Laboratory TypePhysician Office
Certificate Effective DateDecember 11, 2024
Certificate Expiration DateDecember 10, 2026
Laboratory DirectorThomas Mcmeekin
Laboratory Phone(863) 800-3501
Laboratory LocationAcademic Alliance In Dermatology Inc2250 Ospray Blvd Ste. Bldg. A, Tampa, FL 33615
CLIA data matches this NPI record on: Name
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 10D2170738

Academic Alliance In Dermatology Inc · Plant City, FL
Expired · Sep 30, 2026
CLIA Number10D2170738
Laboratory TypePhysician Office
Certificate Effective DateMay 12, 2024
Certificate Expiration DateSeptember 30, 2026
Laboratory DirectorPanayiotis Vasiloudes
Laboratory Phone(813) 882-9986
Laboratory LocationAcademic Alliance In Dermatology Inc1503 West Reynolds St, Plant City, FL 33563
CLIA data matches this NPI record on: Name
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 5

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

DR. MATTHEW BRENT ZOOK MD, PHD
Dermatology
3950 3RD ST N STE A
ST PETERSBURG, FL 33703
Pinellas County (727) 821-0612
LUANNE C HESPELER PA-C
Physician Assistant
3950 3RD ST N STE A
ST PETERSBURG, FL 33703
Pinellas County (727) 821-0612
MS. TIFFANY RENEE TRENT DNP, APRN, AGACNP-BC
Nurse Practitioner
3950 3RD ST N STE A
ST PETERSBURG, FL 33703
Pinellas County (727) 821-0612
MRS. JENNIFER E BEAMGUARD MSPAS, PA-C
Physician Assistant
3950 3RD ST N STE A
ST PETERSBURG, FL 33703
Pinellas County (727) 821-0612
MS. BRETTE BEAN PA-C
Physician Assistant
3950 3RD ST N STE A
SAINT PETERSBURG, FL 33703
Pinellas County (727) 821-0612

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, PLLC's NPI number?

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

Where is Academic Alliance In Dermatology, PLLC located?

Academic Alliance In Dermatology, PLLC 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, PLLC's specialty?

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

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

Yes. 5 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, PLLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Academic Alliance In Dermatology, PLLC 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, PLLC was last updated on September 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 days 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.