LEAVITT MEDICAL ASSOCAITTES OF FLORIDA INC (NPI# 1114218328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114218328 |
| Entity Type | Organization |
| Organization Name | LEAVITT MEDICAL ASSOCAITTES OF FLORIDA INC |
| Other Organization Name | ADVANCED DERMATOLOGY AND COSMETIC SURGERY |
| Practice Address |
1426 E Bloomindale Ave Valrico FL 33596 |
| Mailing Address |
2600 Lake Lucien Dr Suite 180 Maitland FL 32751-7233 |
| Practice Telephone | 8885409660 |
| Practice Fax Number | 4078750518 |
| Mailing Telephone | 4078752080 |
| Mailing Fax Number | 4078750518 |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2011-04-21 |
| Authorized Official Name | NEFRITA LOGAN (PROVIDER SERVICE REP) |
| Authorized Official Telephone | 4078752080 |
| Is Organization Subpart | Y |
| Parent Organization Name | LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Advanced Dermatology and Cosmetic Surgery | Doing Business As Name - Organization |
| Street Address |
1426 E BLOOMINDALE AVE |
| City | VALRICO |
| State | FL |
| Zip Code | 33596 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093271983 | Barbara Jeanne Ross | Registered Nurse | 2322 Longmore Circle, Valrico, FL 33596 | 2019-02-15 |
| 1376023481 | Michelle L Stinehelfer | Physical Medicine & Rehabilitation | 1418 East Bloomingdale Avenue, Valrico, FL 33596 | 2018-08-17 |
| 1487131645 | Nationwide Vision Center, LLC | Technician/Technologist | 2054 E Bloomingdale Ave, Valrico, FL 33596 | 2018-07-20 |
| 1952827305 | Alicia Marie Glasser | Counselor | 3011 Folklore Dr, Valrico, FL 33596 | 2017-08-17 |
| 1811443104 | Yosanna Melendez | Day Training, Developmentally Disabled Services | 4408 Kendal Ct, Valrico, FL 33596 | 2016-08-28 |
| 1689030181 | Wal-mart Stores East, Lp | Technician/Technologist | 2140 Bloomingdale Avenue, Valrico, FL 33596 | 2016-01-13 |
| 1841660008 | Tyler Bradney Love | Physical Therapist | 2470 Bloomingdale Ave, Valrico, FL 33596 | 2015-09-30 |
| 1528499761 | Madeline Horn | Registered Nurse | 2211 Lithia Center Ln, Valrico, FL 33596 | 2013-12-12 |
| 1740614635 | Dr James M Petro Od, Pa | Optometrist | 2140 E Bloomingdale Ave, Located In Wal-mart Vision Center, Valrico, FL 33596 | 2013-08-27 |
| 1134476294 | Ovia Voncile Stephens-oatman | Custodial Care Facility | 4220 Balington Dr, Valrico, FL 33596 | 2012-08-08 |
| Find all providers in zip 33596 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002154 | Precision Skin LLC | Dermatology | 3501 S University Dr Ste 5, Davie, FL 33328-2001 | 2020-10-28 |
| 1487252417 | Janice Reaume | Dermatology | 3335 Imperial Manor Way, Mulberry, FL 33860-5519 | 2020-10-12 |
| 1922617729 | Synergymd, LLC | Dermatology | 1208 E Kennedy Blvd Ste 221, Tampa, FL 33602-3509 | 2020-07-28 |
| 1518585447 | Alexander F Wong | Dermatology | 1300 Goodlette-frank Rd N, Naples, FL 34102-5243 | 2020-07-07 |
| 1508495003 | Elite Dermatology | Dermatology | 401 Coral Way Ste 207, Coral Gables, FL 33134-4924 | 2020-04-06 |
| 1124668371 | Meaghan Margaret Birakis | Dermatology | 3319 Fl-7 #202, Wellington, FL 33449 | 2020-01-15 |
| 1396380044 | Suzanne Marie Smith | Dermatology | 21097 Ne 27th Ct Ste 500, Miami, FL 33180-1235 | 2019-11-15 |
| 1376188383 | Enchantress Dermatology, Inc. | Dermatology | 241 Nw 119 Ave, Miami, FL 33182-1329 | 2019-11-13 |
| 1699319988 | Revivify Dermatology, LLC | Dermatology | 21301 Powerline Rd # 108, Boca Raton, FL 33433-2388 | 2019-10-30 |
| 1841833928 | Carly Marie Maher | Dermatology | 90 Cypress Way E Ste 50, Naples, FL 34110-9275 | 2019-10-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.