LEGENDS DERMATOLOGY, LLC
NPI 1780081869
Dermatology in Davenport, FL

Active since December 04, 2014
1497 LEGENDS BOULEVARD, DAVENPORT, FL 33896(863) 738-5487 Get Directions Write a Review

NPPES record last updated: September 26, 2019. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Legends Dermatology, Llc NPPES

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

LEGENDS DERMATOLOGY, LLC (NPI 1780081869) is a healthcare organization registered as a dermatology in Davenport, Florida and active in the NPI registry since December 2014. The organization lists Iulia Funieru, Sole Owner, as its authorized official.

NPPES Registry Identity

NPI1780081869
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLEGENDS DERMATOLOGY, LLC
Location Address1497 LEGENDS BOULEVARDDavenport, FL 33896
Mailing Address1497 Legends BoulevardDavenport, FL 33896 · (863) 738-5487 · Fax (863) 619-7094
Organization SubpartNo
Authorized OfficialIulia FunieruSole Owner · (863) 738-5487
Enumeration DateDecember 4, 2014
Last NPPES UpdateSeptember 26, 2019
✔ NPI 1780081869 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.
1497 LEGENDS BOULEVARD, Davenport, FL 33896

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Legends Dermatology, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dermatology
NPI 1760435507
1497 LEGENDS BLVD
Champions Gate, FL 33896
(407) 479-2924
✔ PECOS✔ Accepts MedicareSame address

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

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 Legends Dermatology, LLC's NPI number?

The NPI number for Legends Dermatology, LLC is 1780081869. It was assigned to this organization in the NPPES registry on December 4, 2014.

Where is Legends Dermatology, LLC located?

Legends Dermatology, LLC is located at 1497 Legends Boulevard, Davenport, FL 33896. The listed phone number is (863) 738-5487.

What is Legends Dermatology, LLC's specialty?

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

Is Legends Dermatology, LLC enrolled in Medicare?

Yes. Legends Dermatology, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Legends Dermatology, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Legends Dermatology, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Legends Dermatology, LLC was last updated on September 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.