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

3816 Hollywood Blvd
Suite 205
Hollywood, FL 33021-6750

Phone

(954) 966-5409

Fax

(954) 966-0852

NPI assigned

Sep 4, 2009

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) 875-0518

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

Part of

Leavitt Med Dba Advance

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

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271808000000",
    "number": "1215160445",
    "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": "3816 HOLLYWOOD BLVD",
            "address_2": "SUITE 205",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216750",
            "telephone_number": "954-966-5409",
            "fax_number": "954-966-0852"
        }
    ],
    "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": "2009-09-04",
        "last_updated": "2010-04-21",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "NEFRITA",
        "authorized_official_title_or_position": "PROVIDER SERVICE REP",
        "authorized_official_telephone_number": "407-875-0518"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dermatology and Cosmetic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joy Leacock-Jarrett, PT
• Robin Leader-Landau, DO
• Shirley Leader, LMHC
• Leading Kids Therapy Inc
• Leaf It Up Medspa,LLC
• Leavitt Medical Associates of Florida Inc (Advanced Dermatology and Cosmetic Sur)
• Marina Lebrun
• Susan E Lechtenstein, D.O.
• Aron Lechtig, MD
• David Leclair, LCSW

• Dermatology Physician in Hollywood, FL
• Providers in Hollywood, 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.