Organization
ACADEMIC ALLIANCE IN DERMATOLOGY, INC
Active
Parent organization
ACADEMIC ALLIANCE IN DERMATOLOGY, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ACADEMIC ALLIANCE IN DERMATOLOGY, INC
Authorized official
ANGELA RUTH PETERMAN MD (PRESIDENT/OWNER)
(410) 766-0111
Entity
Organization
Contact information
Practice address
6776 54TH AVE N, ST PETERSBURG, FL 33709-1405
(727) 935-0510
(727) 935-0511
Mailing address
5210 WEBB RD, TAMPA, FL 33615-4518
(813) 882-9986
(813) 341-3259
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
Other
Enumeration date
04/20/2022
Last updated
04/21/2022
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