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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) 776-0111
Entity
Organization

Contact information

Practice address
13910 FIVAY RD STE 5, HUDSON, FL 34667-7130
(727) 259-7930
(727) 935-0505
Mailing address
5210 WEBB RD, TAMPA, FL 33615-4518
(813) 882-9986
(813) 882-9849

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician
207ND0900X
Dermatopathology Physician
207NP0225X
Pediatric Dermatology Physician
207NS0135X
Procedural Dermatology Physician

Other

Enumeration date
06/08/2021
Last updated
04/22/2022
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