Leavitt Medical Associates of Florida Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC

Practice address

7310 College Pkwy
Fort Myers, FL 33907-5503

Phone

(888) 540-9660

Fax

(407) 875-0518

NPI assigned

Sep 2, 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) 875-2080

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

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Leavitt Medical Associates of Florida Inc

Practitioners 5

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

• Jay Stuart Gottlieb, DO

  • Dermatology Physician
  • Pembroke Pines, FL
  • NPI 1588660757
  NPD
• Bailey Christine Hart, PA-C

  • Physician Assistant
  • Orange Park, FL
  • NPI 1912521907
  NPD
• Lauren Hartman, PA-C

  • Physician Assistant
  • Boynton Beach, FL
  • NPI 1376094805
  NPD
• Jane J Phillips, PA

  • Physician Assistant
  • Cape Coral, FL
  • NPI 1982686697
  NPD
• Jason Santos, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Miami Beach, FL
  • NPI 1164826442
  NPD

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271808000000",
    "number": "1396978656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 LAKE LUCIEN DR",
            "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": "7310 COLLEGE PKWY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075503",
            "telephone_number": "888-540-9660",
            "fax_number": "407-875-0518"
        }
    ],
    "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": "2009-09-02",
        "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": "407-875-2080"
    },
    "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"
        }
    ]
}

• Cedar Casidy Leaman
• Love Leandre
• Gereiel Monae Leaphart
• Megan Ann Learn, OTR/L, M.S OT
• Vincent Wayne Leaver, LMHC
• Katarzyna Leavitt, MD
• Ronald Leavitt, MD
• Heidi Lynn Lecius, P.T.
• Nadia Ledea Vazquez
• Pamela Margaret Ledward, PAC

• Dermatology Physician in Fort Myers, FL
• Providers in Fort Myers, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.