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GALT DERMATOLOGY & CONCIERGE MEDICINE PA
NPI 1780964460
Specialist in Fort Lauderdale, FL

Active since August 25, 2011CLIA 10D2340664 · Waiver
800 E BROWARD BLVD, SUITE 103, FORT LAUDERDALE, FL 33301(954) 463-5406(954) 522-2456 Get Directions Write a Review

NPPES record last updated: February 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 28, 2025, Feb 22, 2025, Jan 26, 2021 (3 updates tracked since 2021).

About Galt Dermatology & Concierge Medicine Pa NPPES

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

GALT DERMATOLOGY & CONCIERGE MEDICINE PA (NPI 1780964460), doing business as Galt Dermatology, is a healthcare organization registered as a specialist in Fort Lauderdale, Florida and active in the NPI registry since August 2011. The organization holds a CLIA Waiver certificate valid through March 19, 2028 and lists Miguel Villacorta, President, as its authorized official.

NPPES Registry Identity

NPI1780964460
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameGALT DERMATOLOGY & CONCIERGE MEDICINE PA
Location Address800 E BROWARD BLVD, SUITE 103Fort Lauderdale, FL 33301-2008
Mailing Address800 E Broward Blvd, Suite 103Fort Lauderdale, FL 33301-2008 · (954) 463-5406
Phone(954) 463-5406
Fax(954) 522-2456
Organization SubpartNo
Authorized OfficialMiguel VillacortaPresident · (954) 463-5406
Enumeration DateAugust 25, 2011
Last NPPES UpdateFebruary 28, 20253 updates tracked since enumeration
NPPES CertifiedFebruary 28, 2025
✔ NPI 1780964460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in FL · ME36538
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
800 E BROWARD BLVD, Fort Lauderdale, FL 33301
Open in Google Maps ↗

Other Names 1

Doing Business AsGalt Dermatology

Other Identifiers 1

Other1811442668FL · Npi

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

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 10D2340664

Galt Dermatoloty & Concierge Medicine PA · Fort Lauderdale, FL
Active · expires Mar 19, 2028
CLIA Number10D2340664
Laboratory TypePhysician Office
Certificate Effective DateMarch 20, 2026
Certificate Expiration DateMarch 19, 2028
Laboratory DirectorMiguel Villacorta
Laboratory Phone(954) 787-3600
Laboratory LocationGalt Dermatoloty & Concierge Medicine PA800 E Broward Blvd Suite 103, Fort Lauderdale, FL 33301
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

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

ROBERT J. VAN DER LEEST MD, INC.
Dermatology
800 E BROWARD BLVD, SUITE 507
FORT LAUDERDALE, FL 33301
Broward County (954) 736-4331
MS. LINDA DIANE GRACZYK ABOC
Technician/Technologist (Optician)
800 E BROWARD BLVD, SUITE 105
FORT LAUDERDALE, FL 33301
Broward County (954) 764-6962
B HARVEY WIENER, DDS., PA
Dentist (Endodontics)
800 E BROWARD BLVD, SUITE 305
FORT LAUDERDALE, FL 33301
Broward County (954) 463-9191
DR. B HARVEY WIENER DDS., MSCD., FRCD(C)
Dentist (Endodontics)
800 E BROWARD BLVD, SUITE 305
FORT LAUDERDALE, FL 33301
Broward County (954) 463-9191
ROBERT VANDERLEEST MD
Dermatology
800 E BROWARD BLVD, SUITE 507
FORT LAUDERDALE, FL 33301
Broward County (954) 763-4331
VISION-QUEST, INC.
Durable Medical Equipment & Medical Supplies
800 E BROWARD BLVD, SUITE 105
FORT LAUDERDALE, FL 33301
Broward County (954) 764-6962
GINNY BERG, LCSW, INC.
Social Worker (Clinical)
800 E BROWARD BLVD, SUITE 302
FORT LAUDERDALE, FL 33301
Broward County (954) 767-8263
DR. THOMAS KINCAID MCCAWLEY DDS
Dentist
800 E BROWARD BLVD, STE 706
FORT LAUDERDALE, FL 33301
Broward County (954) 522-3228

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 Galt Dermatology & Concierge Medicine PA's NPI number?

The NPI number for Galt Dermatology & Concierge Medicine PA is 1780964460. It was assigned to this organization in the NPPES registry on August 25, 2011. The provider is doing business as Galt Dermatology.

Where is Galt Dermatology & Concierge Medicine PA located?

Galt Dermatology & Concierge Medicine PA is located at 800 E Broward Blvd Suite 103, Fort Lauderdale, FL 33301. The listed phone number is (954) 463-5406.

What is Galt Dermatology & Concierge Medicine PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Galt Dermatology & Concierge Medicine PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2340664) is associated with this NPI, valid through March 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Galt Dermatology & Concierge Medicine PA was last updated on February 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.