Leavitt Medical Associates of Florida Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC

Doing business as

Advanced Dermatology and Cosmetic Surgery

Practice address

2114 Seven Springs Blvd
Suite 250
New Port Richey, FL 34655-3908

Phone

(888) 540-9660

Fax

(407) 875-0518

NPI assigned

Apr 14, 2011

Last updated

Apr 14, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

LEAVITT MEDICAL ASSOCIATES OF FLORIDA INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nefrita Logan

Title

Provider Service Rep

Phone

(407) 875-2080

Specialties & licenses 3

Addresses

Other names 1

• Advanced Dermatology and Cosmetic Surgery Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Part of

Leavitt Med Aso of FL Inc

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302739200000",
    "number": "1023308715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 LAKE LUCIEN DR",
            "address_2": "SUITE 180",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517233",
            "telephone_number": "407-875-2080",
            "fax_number": "407-875-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 SEVEN SPRINGS BLVD",
            "address_2": "SUITE 250",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346553908",
            "telephone_number": "888-540-9660",
            "fax_number": "407-875-0518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC",
        "enumeration_date": "2011-04-14",
        "last_updated": "2011-04-14",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "NEFRITA",
        "authorized_official_title_or_position": "PROVIDER SERVICE REP",
        "authorized_official_telephone_number": "407-875-2080"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dermatology and Cosmetic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neveen Lawandi
• Cassidy Lawless, OD
• Ryan Le, D.D.S.
• Viet Le
• Jay Howard Leathers, MD
• Alfred S. Lee, M.D.
• Bryan David Lee, M.A.
• Kirsten Lee
• Timothy Lee, M.D.
• Yee-Shing Lee, ACUPUNCTURE PHYSICIA

• Dermatology Physician in New Port Richey, FL
• Providers in New Port Richey, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.