Healthcare Provider Details

I. General information

NPI: 1285282533
Provider Name (Legal Business Name): HELIX DERMATOLOGY AND SKIN SURGERY INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9724 N ARMENIA AVE STE 300
TAMPA FL
33612-7550
US

IV. Provider business mailing address

9724 N ARMENIA AVE STE 300
TAMPA FL
33612-7550
US

V. Phone/Fax

Practice location:
  • Phone: 440-804-5996
  • Fax:
Mailing address:
  • Phone: 440-804-5996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. OLGA DEMIDOVA
Title or Position: OWNER
Credential: DO
Phone: 440-804-5996