Healthcare Provider Details

I. General information

NPI: 1619883980
Provider Name (Legal Business Name): NATURE COAST DERMATOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2160 DUCK SLOUGH BLVD STE 103
TRINITY FL
34655-5007
US

IV. Provider business mailing address

2160 DUCK SLOUGH BLVD STE 103
TRINITY FL
34655-5007
US

V. Phone/Fax

Practice location:
  • Phone: 727-807-9070
  • Fax: 727-807-5801
Mailing address:
  • Phone: 727-807-9070
  • Fax: 727-807-5801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LIZA BROWN
Title or Position: DO/PRACTICE OWNER
Credential: DO
Phone: 727-807-9070