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 Surq

Practice address

484 US Highway 1
Ste C
Sebastian, FL 32958-8497

Phone

(772) 646-6100

Fax

(772) 646-6110

NPI assigned

May 30, 2008

Last updated

May 10, 2017By 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

Amy Declue

Title

Director of Provider Services

Phone

(407) 875-2080

Specialties & licenses 4

Addresses

Other names 1

• Advanced Dermatology and Cosmetic Surq Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Part of

Leavitt Medical Associate of Florida Inc

Locations (25 of 58)

Practitioners 250

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• McKenna Bryn Abercrombie Dewees, DO

  • Dermatology Physician
  • Brandon, FL
  • NPI 1902366008
  Medicare reassignment Care Compare group NPD
• Daysi Mariel Abreu, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Riverview, FL
  • NPI 1285119172
  Medicare reassignment Care Compare group NPD
• Adriana Abuchar, PA-C

  • Physician Assistant
  • Boca Raton, FL
  • NPI 1922470814
  Medicare reassignment Care Compare group NPD
• Robert Patrick Albergo, MD

  • Dermatology Physician
  • Palm Harbor, FL
  • NPI 1063496438
  Medicare reassignment Care Compare group NPD
• Niti A Amin, PA-C

  • Physician Assistant
  • Zephyrhills, FL
  • NPI 1114356573
  Medicare reassignment Care Compare group NPD
• Savina Aneja

  • Dermatology Physician
  • Orlando, FL
  • NPI 1184985996
  Medicare reassignment Care Compare group NPD
• Christina Michelle Baden, PA-C

  • Medical Physician Assistant
  • Largo, FL
  • NPI 1750895140

  Dermatology

  Medicare reassignment Care Compare group NPD
• Anais Aurora Badia, DO MD

  • Dermatology Physician
  • Fort Myers, FL
  • NPI 1609051887
  Medicare reassignment Care Compare group NPD
• Michael Barrera

  • Physician Assistant
  • Orlando, FL
  • NPI 1669833232
  Medicare reassignment Care Compare group NPD
• Edmundo Barreto, APRN

  • Family Nurse Practitioner
  • Lehigh Acres, FL
  • NPI 1346909421
  Medicare reassignment Care Compare group NPD
• Caitlin Beach, PA-C

  • Physician Assistant
  • Largo, FL
  • NPI 1801133970
  Medicare reassignment Care Compare group NPD
• Alice Gee-Su Beard, PA-C

  • Physician Assistant
  • Jacksonville, FL
  • NPI 1164532552
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1083872535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN",
            "address_2": "STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517176",
            "telephone_number": "407-875-2080",
            "fax_number": "407-650-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 US HIGHWAY 1",
            "address_2": "STE C",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329588497",
            "telephone_number": "772-646-6100",
            "fax_number": "772-646-6110"
        }
    ],
    "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": "2008-05-30",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "DECLUE",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER SERVICES",
        "authorized_official_telephone_number": "407-875-2080"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dermatology and Cosmetic Surq",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laurie Welton DO PA
• Carrie Laviska, PHARMD
• Connie Lawrence-Willis, O.D.
• Mary Louise Layton, ARNP-C
• Michael Alan Layton, MD
• Clara Lee
• Danielle Lee
• Monica Leppma
• Charles Howard Lind, RPH.
• Lisa R Anthony MD PA

• Dermatology Physician in Sebastian, FL
• Providers in Sebastian, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; 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.