LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC (NPI# 1417115908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417115908 |
| Entity Type | Organization |
| Organization Name | LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC |
| Other Organization Name | ADVANCED DERMATOLOGY AND COSMETIC SURGERY |
| Practice Address |
910 Old Camp Rd Ste 166 The Villages FL 32162-5604 |
| Mailing Address |
2600 Lake Lucien Dr Ste 180 Maitland FL 32751-7235 |
| Practice Telephone | 3522054959 |
| Practice Fax Number | 3522054957 |
| Mailing Telephone | 4078752080 |
| Mailing Fax Number | 4078750518 |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2010-04-21 |
| Authorized Official Name | AMY DECLUE (DIRECTOR, PROVIDER SERVICES) |
| Authorized Official Telephone | 4078752080 |
| Is Organization Subpart | Y |
| Parent Organization Name | LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Advanced Dermatology and Cosmetic Surgery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992095681 | Leavitt Medical Associates of Florida Inc | Dermatology | 3427 Mariner Blvd, Spring Hill, FL 34609-2463 | 2011-04-14 |
| 1477708865 | Leavitt Medical Associates of Florida Inc | Dermatology | 3006 17th St, Saint Cloud, FL 34769-6011 | 2008-11-26 |
| 1952555674 | Leavitt Medical Associates of Florida Inc | Dermatology | 5041 Pine Island Rd Nw, Bokeelia, FL 33922-3269 | 2008-11-07 |
| 1275791758 | Leavitt Medical Associates of Florida Inc | Dermatology | 1816 Salk Ave, Tavares, FL 32778-4300 | 2008-05-30 |
| 1083872535 | Leavitt Medical Associates of Florida Inc | Dermatology | 484 Us Highway 1, Ste C, Sebastian, FL 32958-8497 | 2008-05-30 |
| 1407014996 | Leavitt Medical Associates of Florida Inc | Dermatology | 16100 Ne 16th Ave, North Miami Beach, FL 33162-4708 | 2008-05-30 |
| 1043478522 | Leavitt Medical Associates of Florida Inc | Dermatology | 2101 Us Highway 1, Jupiter, FL 33477-7321 | 2008-05-30 |
| 1710145271 | Leavitt Medical Associates of Florida Inc | Family Medicine | 260 Lookout Pl Ste 103, Maitland, FL 32751-4485 | 2008-05-30 |
| 1427216936 | Leavitt Medical Associates of Florida Inc | Dermatology | 49 Royal Palm Pt Ste 100, Vero Beach, FL 32960-4270 | 2008-05-30 |
| 1891953386 | Leavitt Medical Associates of Florida Inc | Dermatology | 725 W Granada Blvd Ste 44, Ormond Beach, FL 32174-9406 | 2008-05-30 |
| Street Address |
910 OLD CAMP RD STE 166 |
| City | THE VILLAGES |
| State | FL |
| Zip Code | 32162-5604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093219842 | Lisa Hair | Physician Assistant | 910 Old Camp Rd Ste 166, The Villages, FL 32162-5609 | 2018-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831700939 | Lana Nesheiwat | Pharmacist | 2235 Parr Drive, Lady Lake, FL 32162 | 2020-08-12 |
| 1619591393 | Advanced Periodontics & Implant Care, LLC | Dentist | 1950 Laurel Manor Drive #184, The Villages, FL 32162 | 2020-05-29 |
| 1639719081 | Retirement Five, LLC | Skilled Nursing Facility | 16605 Se 74th Souiliere Ave, The Villages, FL 32162 | 2020-01-14 |
| 1184263261 | Eric William Allen | Pharmacist | Win Dixie Pharmacy #2545, 2500 Burnsed Blvd, The Villages, FL 32162 | 2020-01-06 |
| 1740828391 | Tara Maria Jennings Irwin | Physical Therapy Assistant | 11962 Cr 101 #104, The Villages, FL 32162 | 2019-12-13 |
| 1851819254 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 310 Longview Ave, Lady Lake, FL 32162 | 2017-09-06 |
| 1033642327 | Ben Miller | Specialist/Technologist | 251 Buffalo Trl, The Villages, FL 32162 | 2017-04-04 |
| 1932631173 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 620 Kristine Way, The Villages, FL 32162 | 2017-03-28 |
| 1639534522 | Pamela Marie Bureau | Registered Nurse | 1020 Lake Sumter Landing, The Villages, FL 32162 | 2015-12-21 |
| 1669847059 | Dawn Johnson | Dental Assistant | 8900 Mulberry Ln, The Villages, FL 32162 | 2015-12-10 |
| Find all providers in zip 32162 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740703818 | Creekside Dermatology Pa | Dermatology | 8630 E County Road 466 Ste A, The Villages, FL 32162-5614 | 2017-07-20 |
| 1366823775 | Tarek S Shaath | Dermatology | 1040 Lake Sumter Lndg, The Villages, FL 32162-2697 | 2015-06-11 |
| 1518256932 | Sean Mazloom | Dermatology | 1050 Old Camp Rd Ste 150, The Villages, FL 32162-1723 | 2011-04-06 |
| 1023246527 | Charles F Knapp IIi | Dermatology | 2783 Brownwood Blvd, The Villages, FL 32163 | 2009-06-24 |
| 1164614004 | David John Casper | Dermatology | 8620a E County Road 466, The Villages, FL 32162-3670 | 2007-08-14 |
| 1891319422 | Dermatology Institute and Skin Cancer Center LLC | Dermatology | 2783 Brownwood Blvd, The Villages, FL 32163 | 2020-05-29 |
| 1891257655 | Orlando Dermatology Clinic, LLC | Dermatology | 1040 Lake Sumter Lndg, The Villages, FL 32162-2697 | 2019-04-02 |
| 1134440365 | Brandon Max Markus | Dermatology | 2783 Brownwood Blvd, The Villages, FL 32163 | 2010-06-22 |
| 1427180645 | Florida Dermatologic Surgery & Aesthetics Institute Pa | Dermatology | 11950 County Road 101, Suite 203, The Villages, FL 32162-9332 | 2007-03-12 |
| 1891805149 | Michelle Thomas Snider | Dermatology | 1950 Laurel Manor Dr, Suite 224, The Villages, FL 32162-5603 | 2006-08-30 |
| Find all providers in THE VILLAGES | ||||
| City | THE VILLAGES |
| Zip Code | 32162 |
Please comment or provide details below to improve the information on LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.