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LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC NPI 1528097284


NPI Information

NPI: 1528097284
Provider Name: LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC

Doing Business As: ADVANCED DERMATOLOGY AND COSMETIC SURGERY

Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 10D0973519

Address:
120 INTERNATIONAL PKWY
240
HEATHROW, FL
ZIP 32746
Phone: (407) 333-4200
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LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC is a dermatology in Heathrow, FL. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC NPI is 1528097284. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Advanced Dermatology And Cosmetic Surgery.

The provider's business location address is:

120 INTERNATIONAL PKWY
240
HEATHROW, FL
ZIP 32746-031
Phone: (407) 333-4200
Fax: (407) 829-6637

The provider's authorized official is Amy Declue .
The authorized official title is Director Of Provider Services and has the following contact phone number (407) 875-2080.

The CLIA number assigned to this NPI record is 10D0973519 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/2/2006 and was last updated on 8/29/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207ND0101XDermatologyMOHS-Micrographic SurgeryOS5365FLORIDANo
2207ND0900XDermatologyDermatopathologyOS5365FLORIDANo
3207NP0225XDermatologyPediatric DermatologyOS5365FLORIDANo
4207NS0135XDermatologyProcedural DermatologyOS5365FLORIDANo
5207Q00000XFamily MedicineOS5365FLORIDANo
6207RA0201XInternal MedicineAllergy & ImmunologyOS5365FLORIDANo
7208200000XPlastic SurgeryOS5365FLORIDANo
8208600000XSurgeryOS5365FLORIDANo
9207N00000XDermatologyOS5365FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
198046BMEDICARE PINFLORIDA
298046HMEDICARE PINFLORIDA
3256877200MEDICAIDFLORIDA
498046MEDICARE PINFLORIDA
598046AMEDICARE PINFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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