Leavitt Medical Associates of Florida Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC

Practice address

6705 S Red Rd
Suite 518
South Miami, FL 33143-3622

Phone

(305) 403-1181

Fax

(305) 403-1230

NPI assigned

May 30, 2008

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

Pro Ser Rep

Phone

(407) 875-2080

Specialties & licenses 4

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 Medical Associates of Florida Inc

Locations

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271808000000",
    "number": "1164680658",
    "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": "6705 S RED RD",
            "address_2": "SUITE 518",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331433622",
            "telephone_number": "305-403-1181",
            "fax_number": "305-403-1230"
        }
    ],
    "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": "2010-04-21",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "NEFRITA",
        "authorized_official_title_or_position": "PRO SER REP",
        "authorized_official_telephone_number": "407-875-2080"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "advanced dermatology and cosmetic surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Annmarie Law, PH.D.
• Lawrence M Welkovich MD PA
• Jerry Marshal Layne, M.D., D.D.S.
• Yohana Leal Darias Sr.
• Vanessa Alida Leal-de Rojas, ARNP-BC
• Eric K Lebbeney-Bandar, D.O., MSC
• Andre Christian Ledoux, DMD
• Clarice Angelica Lee, MT-BC
• Hayoung Lee
• Rosemary Koehl Lee, ARNP

• Dermatology Physician in South Miami, FL
• Providers in South Miami, 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 21, 2010; 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.