BRANDON DERMATOLOGY P A
NPI 1760504682
Dermatology in Brandon, FL

Q: What is Brandon Dermatology P A's NPI number?

The NPI number for Brandon Dermatology P A is 1760504682. It was assigned to this organization in the NPPES registry on April 3, 2007.

Q: What is Brandon Dermatology P A's specialty?

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

Active since April 03, 2007CLIA Certified · 2 labs

405 W BLOOMINGDALE AVE, BRANDON, FL 33511(813) 662-3376(813) 662-3009 Get Directions Write a Review

NPPES record last updated: September 19, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Brandon Dermatology P A NPPES

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

BRANDON DERMATOLOGY P A (NPI 1760504682) is a healthcare organization registered as a dermatology in Brandon, Florida and active in the NPI registry since April 2007. The organization holds 2 active CLIA laboratory certificates and lists Andres Tobon, Presidentphysician, as its authorized official.

NPPES Registry Identity

NPI1760504682

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameBRANDON DERMATOLOGY P A

Location Address405 W BLOOMINGDALE AVEBrandon, FL 33511-7401

Mailing Address405 W Bloomingdale AveBrandon, FL 33511-7401 · (813) 662-3376 · Fax (813) 662-3009

Phone(813) 662-3376

Fax(813) 662-3009

Organization SubpartNo

Authorized OfficialAndres TobonPresidentphysician · (813) 662-3376

Enumeration DateApril 3, 2007

Last NPPES UpdateSeptember 19, 2008

✔ NPI 1760504682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in FL · OS7868

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.

405 W BLOOMINGDALE AVE, Brandon, FL 33511

Open in Google Maps ↗

Other Identifiers 1

OtherAL785FL · Medicare Ptan

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

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

CLIA Laboratory Certificates CMS CLIA 2

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 10D2275813

Brandon Dermatology, PA · Brandon, FL

Active · expires Jan 29, 2027

CLIA Number10D2275813

Laboratory TypePhysician Office

Certificate Effective DateJanuary 30, 2025

Certificate Expiration DateJanuary 29, 2027

Laboratory DirectorAndres Tobon

Laboratory Phone(813) 662-3376

Laboratory LocationBrandon Dermatology, PA405 W Bloomingdale Ave, Brandon, FL 33511

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 10D2020895

Brandon Dermatology PA · Brandon, FL

Active · expires Jan 5, 2027

CLIA Number10D2020895

Laboratory TypePhysician Office

Certificate Effective DateJanuary 6, 2025

Certificate Expiration DateJanuary 5, 2027

Laboratory DirectorDr. Ritika T. Bhandari

Laboratory Phone(813) 662-3376

Laboratory LocationBrandon Dermatology PA406 W Bloomingdale Ave, Brandon, FL 33511

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 7

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

MRS. SHANNON RACHELLE CARIE PA-C

Physician Assistant