MEDICARE: LUX DERMATOLOGY HAIR & SKIN INSTITUTE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1407558562
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUX DERMATOLOGY HAIR & SKIN INSTITUTE LLC

Provider Business Mailing Address
First Line	:	4004 S MACDILL AVE STE 2
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-1551
Country	:	US
Telephone Number	:	813-709-8681
Fax Number	:	813-725-1611

Provider Business Practice Location Address
First Line	:	4004 S MACDILL AVE STE 2
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-1551
Country	:	US
Telephone Number	:	813-669-5455
Fax Number	:

Authorized Official
Title or Position	:	CEO/DERMATOLOGIST
Name	:	CHAUNCEY CALDWELL BARBULESCU
Credential	:	MD
Telephone Number	:	507-202-5713

Provider Enumeration Date	:	03/21/2023
Last Update Date	:	04/08/2026

Similar Medicare Providers

1730574898 — CHAUNCEY CALDWELL BARBULESCU MD
Practice Location Address:

4004 S MACDILL AVE STE 2
TAMPA, FL
33611-1551

Practice Phone: 813-709-8681
Practice Fax: 813-725-1611

1427470780 — MEDICASCRIPTS PHARMACY
Practice Location Address:

1551 N. FLORIDA AVE
TAMPA, FL
33613

Practice Phone: 813-968-0520
Practice Fax: 813-968-0482

1235814252 — MS. TIA TAMERA STEWARD
Practice Location Address:

11212 MOONVALLEY WAY
TAMPA, FL
33635-1551

Practice Phone: 813-787-6078
Practice Fax:

1972970473 — CARA BRYAN MA, CCC/SLP
Practice Location Address:

4707 W GANDY BLVD STE 3
TAMPA, FL
33611-3310

Practice Phone: 813-728-6601
Practice Fax: 813-354-4800

1619802535 — NADA SHOKOR
Practice Location Address:

2927 POINTEVIEW DR
TAMPA, FL
33611-5343

Practice Phone: 813-550-9754
Practice Fax:

1760369557 — FOLASHADE DEBORAH IJOMA
Practice Location Address:

4610 S MANHATTAN AVE
TAMPA, FL
33611-2308

Practice Phone: 813-839-5311
Practice Fax:

Directions to “LUX DERMATOLOGY HAIR & SKIN INSTITUTE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.