LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC (NPI# 1881925006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881925006 |
| Entity Type | Organization |
| Organization Name | LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC |
| Other Organization Name | ADVANCED DERMATOLOGY AND COSMETIC SUREGERY |
| Practice Address |
1515 W Nasa Blvd Ste 100 Melbourne FL 32901-2605 |
| Mailing Address |
151 Southhall Ln Ste 300 Maitland FL 32751-7176 |
| Practice Telephone | 3213080659 |
| Practice Fax Number | 3213092881 |
| Mailing Telephone | 4078752080 |
| Mailing Fax Number | 4076503455 |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2013-12-09 |
| 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 |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | FL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Advanced Dermatology and Cosmetic Suregery | 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 |
1515 W NASA BLVD STE 100 |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-2605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013957133 | Anthony Jerome Porter | Dermatology | 1515 W Nasa Blvd, Suite 101, Melbourne, FL 32901-2605 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| 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 |
|---|---|---|---|---|
| 1205290913 | Megan Marie Cronin | Dermatology | 1399 S. Harbor City Blvd, Melbourne, FL 32901-3208 | 2016-04-08 |
| 1912217928 | Stuart A Walek Md Pa | Dermatology | 4314 Ligustrum Dr, Melbourne, FL 32934-8603 | 2010-10-12 |
| 1104152495 | Porter Premier Dermatology and Surgery Center, Pllc | Dermatology | 1515 W Nasa Blvd Ste 101, Melbourne, FL 32901-2605 | 2009-10-22 |
| 1174614663 | Stephen H Hornell | Dermatology | 333 E Sheridan Rd, Melbourne, FL 32901-3152 | 2006-09-27 |
| 1942227814 | Sandra K Shrader | Dermatology | 1700 W Hibiscus Blvd, Melbourne, FL 32901-2615 | 2006-07-16 |
| 1023046885 | Peter Mangone Zies | Dermatology | 17 East Silver Palm Avenue, Melbourne, FL 32901-3123 | 2006-06-29 |
| 1013957133 | Anthony Jerome Porter | Dermatology | 1515 W Nasa Blvd, Suite 101, Melbourne, FL 32901-2605 | 2006-06-07 |
| 1275594277 | Rosalind A Freas | Dermatology | 2571 W Eau Gallie Blvd, Suite 2, Melbourne, FL 32935-8954 | 2006-03-29 |
| 1598732471 | Stacia Poole | Dermatology | 930s Harbor City Blvd 101, Melbourne, FL 32901-1901 | 2006-03-01 |
| 1447234000 | Anita Saluja | Dermatology | 6559 N Wickham Rd Ste C-105, Melbourne, FL 32940-2039 | 2005-12-06 |
| Find all providers in MELBOURNE | ||||
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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.