LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC (NPI# 1205094778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205094778 |
| Entity Type | Organization |
| Organization Name | LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC |
| Other Organization Name | ADVANCED DERMATOLOGY AND COSMETIC SURGERY |
| Practice Address |
1507 Park Center Dr Unit 1d1e Orlando FL 32835-5795 |
| Mailing Address |
2600 Lake Lucien Dr Ste 180 Maitland FL 32751-7235 |
| Practice Telephone | 4074459445 |
| Practice Fax Number | 4072933908 |
| Mailing Telephone | 4078752080 |
| Mailing Fax Number | 4078750518 |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2010-04-21 |
| Authorized Official Name | AMY DECLUE (DIRECTOR, PROVIDER SERVICES) |
| 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 | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 256877207 | 05 |
| Other Name | Type Code |
|---|---|
| Advanced Dermatology and Cosmetic Surgery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992095681 | Leavitt Medical Associates of Florida Inc | Dermatology | 3427 Mariner Blvd, Spring Hill, FL 34609-2463 | 2011-04-14 |
| 1477708865 | Leavitt Medical Associates of Florida Inc | Dermatology | 3006 17th St, Saint Cloud, FL 34769-6011 | 2008-11-26 |
| 1952555674 | Leavitt Medical Associates of Florida Inc | Dermatology | 5041 Pine Island Rd Nw, Bokeelia, FL 33922-3269 | 2008-11-07 |
| 1275791758 | Leavitt Medical Associates of Florida Inc | Dermatology | 1816 Salk Ave, Tavares, FL 32778-4300 | 2008-05-30 |
| 1083872535 | Leavitt Medical Associates of Florida Inc | Dermatology | 484 Us Highway 1, Ste C, Sebastian, FL 32958-8497 | 2008-05-30 |
| 1407014996 | Leavitt Medical Associates of Florida Inc | Dermatology | 16100 Ne 16th Ave, North Miami Beach, FL 33162-4708 | 2008-05-30 |
| 1043478522 | Leavitt Medical Associates of Florida Inc | Dermatology | 2101 Us Highway 1, Jupiter, FL 33477-7321 | 2008-05-30 |
| 1710145271 | Leavitt Medical Associates of Florida Inc | Family Medicine | 260 Lookout Pl Ste 103, Maitland, FL 32751-4485 | 2008-05-30 |
| 1417115908 | Leavitt Medical Associates of Florida Inc | Dermatology | 910 Old Camp Rd Ste 166, The Villages, FL 32162-5604 | 2008-05-30 |
| 1427216936 | Leavitt Medical Associates of Florida Inc | Dermatology | 49 Royal Palm Pt Ste 100, Vero Beach, FL 32960-4270 | 2008-05-30 |
| Street Address |
1507 PARK CENTER DR UNIT 1D1E |
| City | ORLANDO |
| State | FL |
| Zip Code | 32835-5795 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750849998 | Elham Miraliakbari | Physician Assistant | 1507 Park Center Dr Unit 1d1e, Orlando, FL 32835-5795 | 2019-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558912006 | Ork Medical | Family Medicine | 2441 South Hiawassee Road, Orlando, FL 32835 | 2019-09-26 |
| 1104480011 | Anna Linn Patterson | Counselor | 7601 Conroy-windermere Rd, Suite 202, Orlando, FL 32835 | 2019-04-25 |
| 1134695190 | Tammera Black | Clinic/Center | 1969 Westpointe Cir, Orlando, FL 32835 | 2018-10-17 |
| 1821570268 | Christopher James Martin | Physical Therapy Assistant | 117 Lake Dr, Orlando, FL 32835 | 2018-09-02 |
| 1396250098 | Advanced Kid's Care | Pediatrics | 98 Terra Mango Loop, Unit 12, Orlando, FL 32835 | 2017-12-05 |
| 1700303591 | Serenity Home Care & Services | Adult Companion | 2301 Lake Debra Drive Apt 112, Orlando, FL 32835 | 2017-08-23 |
| 1003332743 | Shawanda Wright | Behavioral Analyst | 672 Bellhurst Court, Orlando, FL 32835 | 2017-08-15 |
| 1578092979 | Chrystal Dawn Liebold | Social Worker | 3344 Robert Trent Jones Drive, Unit 101, Orlando, FL 32835 | 2017-06-08 |
| 1497280002 | Adventist Health System/sunbelt, Inc | Family Medicine | 8014 Conroy Windermere Rd, Suite 104, Orlando, FL 32835 | 2017-04-21 |
| 1336680222 | Agile Physical Therapy & Wellness Center LLC | Clinic/Center | 6735 Conroy Windermere Rd, Suite 223, Orlando, FL 32835 | 2017-03-13 |
| Find all providers in zip 32835 | ||||
| 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 |
|---|---|---|---|---|
| 1902209844 | Jennifer Lynn Brinckerhoff | Dermatology | 4750 The Grove Drive Ste 280, Orlando, FL 32819 | 2014-10-07 |
| 1184985996 | Savina Aneja | Dermatology | 9368 Narcoossee Rd Ste 104, Orlando, FL 32827-5704 | 2012-06-07 |
| 1275805921 | Nicole Swenson | Dermatology | 2116 S Orange Ave Ste C, Orlando, FL 32806 | 2012-01-27 |
| 1932490778 | Lina Maria Cardona | Dermatology | 829 Woodbury Rd Ste 103, Orlando, FL 32828 | 2011-04-27 |
| 1255639357 | Sasha Gay Ashmeade | Dermatology | 10727 Narcoossee Rd Ste B6, Orlando, FL 32832-6943 | 2011-03-14 |
| 1821227133 | Monique Gupta Kumar | Dermatology | 615 E Princeton St Ste 416, Orlando, FL 32803-1469 | 2009-07-08 |
| 1205032497 | Kevin Spohr | Dermatology | 1507 Park Center Drive, Unit 1d, Orlando, FL 32835 | 2007-06-25 |
| 1518929116 | Dzi-long Newman | Dermatology | 80 W Gore St, Orlando, FL 32806-1114 | 2006-04-06 |
| 1023097623 | Elana L Shackelford | Dermatology | 1111 S. Orange Ave, 4th Floor, Orlando, FL 32806 | 2006-01-11 |
| 1285634550 | Steven Marc Price | Dermatology | 300 E Hazel St, Orlando, FL 32804-4023 | 2005-07-28 |
| Find all providers in ORLANDO | ||||
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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.