LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC (NPI# 1487812947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487812947 |
| Entity Type | Organization |
| Organization Name | LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC |
| Other Organization Name | ADVANCED DERMATOLOGY AND COSMETIC SUR |
| Practice Address |
1905 Clint Moore Rd Suite 103 Boca Raton FL 33496-2658 |
| Mailing Address |
151 Southhall Ln Ste 300 Maitland FL 32751-7176 |
| Practice Telephone | 5612414474 |
| Practice Fax Number | 5612419667 |
| Mailing Telephone | 4078752080 |
| Mailing Fax Number | 4076503455 |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2014-12-04 |
| 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 | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Advanced Dermatology and Cosmetic Sur | 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 |
1905 CLINT MOORE RD SUITE 103 |
| City | BOCA RATON |
| State | FL |
| Zip Code | 33496-2658 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831174242 | Brian K Kaplan | Internal Medicine | 1905 Clint Moore Rd, Suite 204, Boca Raton, FL 33496-2658 | 2005-12-08 |
| 1255970760 | Exillette Etienne Camille | Nurse Practitioner | 1905 Clint Moore Rd, Boca Raton, FL 33496-2658 | 2019-12-31 |
| 1578914800 | Jennifer Maria Gold | Physician Assistant | 1905 Clint Moore Rd, Suite 215, Boca Raton, FL 33496-2658 | 2016-06-28 |
| 1083073423 | Mr Health Group LLC | Clinic/Center | 1905 Clint Moore Rd, Ste 305, Boca Raton, FL 33496-2658 | 2016-02-13 |
| 1578932216 | Caroline E Rangel | Physician Assistant | 1905 Clint Moore Rd, Suite 309, Boca Raton, FL 33496-2658 | 2015-09-23 |
| 1083092829 | Central Palm Beach Physicians & Urgent Care Inc | Specialist | 1905 Clint Moore Rd, Suite 308, Boca Raton, FL 33496-2658 | 2015-05-13 |
| 1114304102 | Daniel S. Kovacs, M.d., P.a. | Plastic Surgery | 1905 Clint Moore Rd, Suite 101, Boca Raton, FL 33496-2658 | 2015-04-29 |
| 1497145957 | Stewart M. Kaskel M.d. | Internal Medicine | 1905 Clint Moore Rd, Ste 310, Boca Raton, FL 33496-2658 | 2015-02-04 |
| 1154735819 | Elite Dermatology and Aesthetic Institute, LLC | Family Medicine | 1905 Clint Moore Rd, Suite 203, Boca Raton, FL 33496-2658 | 2014-06-20 |
| 1427490002 | Cranial Technologies Inc | Prosthetic/Orthotic Supplier | 1905 Clint Moore Rd, Suite 301, Boca Raton, FL 33496-2658 | 2013-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275193708 | Georgia Management Group | Health Maintenance Organization | 9878 Clint Moore Rd Suite 206, Boca Raton, FL 33496 | 2019-06-17 |
| 1326505710 | Capital Ortho LLC | Durable Medical Equipment & Medical Supplies | 6599 Newport Lake Cir, Boca Raton, FL 33496 | 2019-02-21 |
| 1710409636 | Armando Rodriguez | Specialist/Technologist | 9975 Boca Gardens Trail, Unit C, Boca Raton, FL 33496 | 2017-07-12 |
| 1942721782 | Lang Thi Woodmansee | Optometrist | 17940 S Military Trl Ste 400, Boca Raton, FL 33496 | 2017-07-02 |
| 1710325006 | Home Care Assistance of South Florida, LLC | Home Health | 3050 Champion Blvd., Boca Raton, FL 33496 | 2013-06-07 |
| 1568704450 | Gary J Edman | Physician Assistant | 4705 N Federal Highway, Boca Raton, FL 33496 | 2013-03-19 |
| 1396065512 | Holiday Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 6651 N. Military Trail, Suite 100, Boca Raton, FL 33496 | 2010-06-10 |
| 1265765093 | Mark Alan Needle | Internal Medicine | 2231 Nw 58 St, Boca Raton, FL 33496 | 2009-09-11 |
| 1780834036 | Richard Allen Peshkin | General Practice | 5227-a Lake Catalina Dr. N, Boca Raton, FL 33496 | 2008-09-23 |
| 1073712071 | Ehsan Esmaeili | Surgery | 1905 Clint Moore Rd., Suite 105, Boca Raton, FL 33496 | 2007-07-11 |
| Find all providers in zip 33496 | ||||
| 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 |
|---|---|---|---|---|
| 1699319988 | Revivify Dermatology, LLC | Dermatology | 21301 Powerline Rd # 108, Boca Raton, FL 33433-2388 | 2019-10-30 |
| 1770144123 | Mobile Dermatology Care Pllc | Dermatology | 4700 Exchange Ct Ste 110, Boca Raton, FL 33431-4450 | 2019-06-26 |
| 1790171353 | Eric Rudnick | Dermatology | 22029 State Road 7 Ste 1, Boca Raton, FL 33428-4200 | 2015-04-10 |
| 1649616970 | Moum Dermatology LLC | Dermatology | 445 S Federal Hwy, Boca Raton, FL 33432-6027 | 2013-05-14 |
| 1114361235 | Dermpartners Inc | Dermatology | 21020 State Rd 7, Suite 120, Boca Raton, FL 33428 | 2013-04-19 |
| 1831410315 | Kenneth Jon Folsom | Dermatology | 3902 Nw 23rd Ct, Boca Raton, FL 33431-5446 | 2010-06-18 |
| 1588810808 | Lloyd George Wickboldt | Dermatology | 6630 Patio Ln, Boca Raton, FL 33433-6631 | 2008-08-18 |
| 1417115304 | Channing Rachel Barnett | Dermatology | 7100 W Camino Real Ste 301, Boca Raton, FL 33433-5510 | 2008-05-28 |
| 1164626545 | Patricia Sara Klem | Dermatology | 1905 Clint Moore Rd. Ste. 103, Advanced Dermatology, Boca Raton, FL 33496 | 2007-06-12 |
| 1255545547 | John Alan Kulick | Dermatology | 22804 Marbella Circle, Boca Raton, FL 33433-3802 | 2007-05-09 |
| Find all providers in BOCA RATON | ||||
| City | BOCA RATON |
| Zip Code | 33496 |
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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.