Leavitt Medical Associates of Florida Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC

Practice address

4970 W Atlantic Blvd
Margate, FL 33063-5300

Phone

(954) 977-0270

Fax

(954) 977-6924

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

Amy Declue

Title

Director, Provider Services

Phone

(407) 875-2080

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Advanced Dermatology and Cosmetic Sur Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Part of

Leavitt Medical Associates of Florida Inc

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William C. Chow, D.O.

  • Specialist
  • Oakland, CA
  • NPI 1417981192
  NPD

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1306004866",
    "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": "4970 W ATLANTIC BLVD",
            "city": "MARGATE",
            "state": "FL",
            "postal_code": "330635300",
            "telephone_number": "954-977-0270",
            "fax_number": "954-977-6924"
        }
    ],
    "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": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "DECLUE",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "DIRECTOR, PROVIDER SERVICES",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256811226",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dermatology and Cosmetic Sur",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Frank Grant Lassiter, D.C.
• Michael Alexander Last, MD
• Laxmi Healthcare LLC
• Laurie A Leach, OT
• Leave No One Behind Inc.
• Shinnelle Lebrun
• Dbora Lee, PA-C
• Matthew H. Lee, MD
• Heidi Leek, OT
• Legacy Healing and Treatment New Jersey LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.