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State Wide Dermatology LLC

Dermatology Physician in Odessa, FL · enumerated 2014 · authorized official Kathleen Harrell, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1427473073

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Registry record

Entity type Organization (Type 2)
Legal business name State Wide Dermatology LLC
Practice address 17121 Rainbow Ter, Odessa, FL, 33556
Phone (813) 749-6907
Fax (813) 475-7831
Enumeration date Feb 19, 2014
Last updated in NPPES Jul 28, 2014

Taxonomy & classification

207N00000X Dermatology Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Kathleen Harrell
Title Owner
Phone (813) 749-6907

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What type of organization is State Wide Dermatology LLC?
State Wide Dermatology LLC is registered in NPPES as a Dermatology Physician (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-07-28.