Leavitt Medical Associates of Florida Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC

Practice address

410 Celebration PL
Suite 301
Celebration, FL 34747-5433

Phone

(407) 566-1616

Fax

(407) 566-1617

NPI assigned

Apr 2, 2009

Organization subpart

No

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

Authorized official

Name

Nefrita Logan

Title

Provider Representative

Phone

(407) 875-2080

Specialties & licenses 1

Addresses

Other names 1

• Advanced Dermatology and Cosmetic Surgery Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238630400000",
    "number": "1194967331",
    "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": "410 CELEBRATION PL",
            "address_2": "SUITE 301",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475433",
            "telephone_number": "407-566-1616",
            "fax_number": "407-566-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-02",
        "last_updated": "2009-04-02",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "NEFRITA",
        "authorized_official_title_or_position": "PROVIDER REPRESENTATIVE",
        "authorized_official_telephone_number": "407-875-2080"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dermatology and Cosmetic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luella Sharon Laroche, LMHC
• Lewis C Larson, DMD
• Victoria Larson, MD
• Alexander Minh Hieu Le, PHARMD
• Derek Leaderer, M.D.
• Monica Leibacher, LMT, CST
• Robert F Lemert, M.D.
• Jose Guillermo Leon-Burgos, PHARMD
• Handerson Leon, APRN
• Brian Leonard, PHARMD

• Dermatology Physician in Celebration, FL
• Providers in Celebration, 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 2, 2009; 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.