LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC (NPI# 1619287844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619287844 |
| Entity Type | Organization |
| Organization Name | LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC |
| Other Organization Name | ADVANCED DERMATOLOGY AND COSMETIC SURGERY |
| Practice Address |
1513 S Harbor City Blvd Melbourne FL 32901-4681 |
| Mailing Address |
151 Southhall Ln Suite 300 Maitland FL 32751-7176 |
| Practice Telephone | 3219512639 |
| Practice Fax Number | 8669488094 |
| Mailing Telephone | 4078752080 |
| Mailing Fax Number | 4078750518 |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2013-10-02 |
| Authorized Official Name | NEFRITA LOGAN (REP) |
| Authorized Official Telephone | 4078752080 |
| Authorized Official Credential | PROVIDER SERVICE |
| Is Organization Subpart | Y |
| Parent Organization Name | LEAVITT MEDICAL ASSOCIATES OF FLORIDA INCE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| Y | 208200000X | Plastic Surgery | 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 |
| 1417115908 | Leavitt Medical Associates of Florida Inc | Dermatology | 910 Old Camp Rd Ste 166, The Villages, FL 32162-5604 | 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 |
| Street Address |
1513 S HARBOR CITY BLVD |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-4681 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295748176 | Michael Diaz | Specialist | 1513 S Harbor City Blvd, Melbourne, FL 32901 | 2006-08-14 |
| 1801305032 | Amy Limonta | Nurse Practitioner | 1513 S Harbor City Blvd, Melbourne, FL 32901-4681 | 2017-09-19 |
| 1962958397 | Michael Diaz M.d. P.a. | Plastic Surgery | 1513 S Harbor City Blvd, Melbourne, FL 32901-4681 | 2016-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295278943 | Florida Dermatology Plastic Surgery LLC | Plastic Surgery | 6559 N Wickham Rd, Suite 105, Melbourne, FL 32940-2039 | 2016-11-29 |
| 1962958397 | Michael Diaz M.d. P.a. | Plastic Surgery | 1513 S Harbor City Blvd, Melbourne, FL 32901-4681 | 2016-08-26 |
| 1821362609 | Cory J Lawler, Md, Pa | Plastic Surgery | 1700 W Hibiscus Blvd, Melbourne, FL 32901-2615 | 2012-02-27 |
| 1326374901 | Bermax II LLC | Plastic Surgery | 707 W Eau Gallie Blvd, Melbourne, FL 32935-5958 | 2009-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275166720 | Ph1 Miami | Plastic Surgery | 8585 Sw 72nd St Ste 107, Miami, FL 33143-3746 | 2020-02-12 |
| 1720619927 | Jhs Surgical Pavillion LLC | Plastic Surgery | 3319 S State Road 7 Ste 107, Wellington, FL 33449-8099 | 2020-01-28 |
| 1861048498 | Alexandra Conde Green Md Pa | Plastic Surgery | 4788 N Citation Dr Apt 105, Delray Beach, FL 33445-6532 | 2019-08-09 |
| 1962062885 | Zunilda Rodriguez Martinez | Plastic Surgery | 7360 Sw 24th St, Miami, FL 33155-1498 | 2019-06-13 |
| 1962960146 | Elite Surgery Center, LLC | Plastic Surgery | 5301 4th Ave Circle E, Bradenton, FL 34208 | 2019-03-07 |
| 1508335985 | Plastic Surgery Associates of Miami | Plastic Surgery | 6541 Sw 76th Ter, South Miami, FL 33143-4656 | 2018-11-15 |
| 1023592177 | Lake Mary Plastic and Cosmetic Surgery Pa | Plastic Surgery | 934 Williston Park Pt Ste 1028, Lake Mary, FL 32746-2165 | 2018-09-24 |
| 1790271096 | Rsm Plastic Surgery, Pa | Plastic Surgery | 3300 W Lake Mary Blvd Ste 210, Lake Mary, FL 32746-3499 | 2018-07-10 |
| 1609306877 | South Beach Plastic Surgery, P.a. | Plastic Surgery | 1820 James Ave Apt 6d, Miami Beach, FL 33139-7462 | 2017-06-19 |
| 1861947996 | Harlan Ira Wald | Plastic Surgery | 1501 Se 10th St, Fort Lauderdale, FL 33316-1419 | 2016-08-18 |
| Find all providers with the same taxonomy | ||||
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| 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.