VITAL DERMATOLOGY
NPI 1386289585
Dermatology in Pensacola, FL

Active since November 12, 2019CLIA 10D2218056 · Waiver
6202 N 9TH AVE STE 2, PENSACOLA, FL 32504(850) 888-2424(620) 710-7703 Get Directions Write a Review

NPPES record last updated: May 3, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 25, 2019, Nov 12, 2019 (2 updates tracked since 2019).

About Vital Dermatology NPPES

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

VITAL DERMATOLOGY (NPI 1386289585) is a healthcare organization registered as a dermatology in Pensacola, Florida and active in the NPI registry since November 2019. The organization holds a CLIA Waiver certificate valid through March 24, 2027 and lists Jenna Beasley, Owner, as its authorized official.

NPPES Registry Identity

NPI1386289585
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameVITAL DERMATOLOGY LLC
Location Address6202 N 9TH AVE STE 2Pensacola, FL 32504-8291
Mailing Address6202 N 9th Ave Ste 2Pensacola, FL 32504-8291 · (850) 888-2424 · Fax (620) 710-7703
Fax(620) 710-7703
Organization SubpartNo
Authorized OfficialJenna BeasleyOwner · (850) 888-2424
Enumeration DateNovember 12, 2019
Last NPPES UpdateMay 3, 20202 updates tracked since enumeration
NPPES CertifiedMay 3, 2020
NPI 1386289585 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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.

6202 N 9TH AVE STE 2, Pensacola, FL 32504

Other Names 1

Doing Business AsVital Dermatology

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

Accepted Insurance

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 of Waiver 10D2218056

Vital Dermatology LLC · Pensacola, FL
Active · expires Mar 24, 2027
CLIA Number10D2218056
Laboratory TypePhysician Office
Certificate Effective DateMarch 25, 2025
Certificate Expiration DateMarch 24, 2027
Laboratory DirectorJenna M. Beasley
Laboratory Phone(850) 888-2424
Laboratory LocationVital Dermatology LLC6202 N 9th Ave Suite 2, Pensacola, FL 32504
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

Dermatology
6202 N 9TH AVE STE 2
PENSACOLA, FL 32504
Dermatology
6202 N 9TH AVE STE 2
PENSACOLA, FL 32504

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1386289585, enumerated as an "organization" on November 12, 2019.

The provider is located at 6202 N 9TH AVE STE 2 PENSACOLA, FL 32504 and the phone number is (850) 888-2424.

Dermatology with taxonomy code 207N00000X.

The provider might be accepting Accepts: Ambetter Health and Ambetter of Alabama. Please consult your insurance carrier or call the provider to verify.