LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC (NPI# 1700044286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700044286 |
| Entity Type | Organization |
| Organization Name | LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC |
| Other Organization Name | ADVANCED DERMATOLOGY AND COSMETIC SURGERY |
| Practice Address |
1503 Buenos Aires Blvd The Villages FL 32159-6821 |
| Mailing Address |
2600 Lake Lucien Dr Ste 180 Maitland FL 32751-7235 |
| Practice Telephone | 3527532812 |
| Practice Fax Number | 3527535037 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 256877220 | 05 |
| 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 |
1503 BUENOS AIRES BLVD |
| City | THE VILLAGES |
| State | FL |
| Zip Code | 32159-6821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750383980 | Rakesh Rohatgi | Internal Medicine | 1503 Buenos Aires Blvd, Bldg 140, The Villages, FL 32159-6823 | 2005-06-01 |
| 1528541166 | Sara Michele Rojek | Physician Assistant | 1503 Buenos Aires Blvd, The Villages, FL 32159-6821 | 2018-09-10 |
| 1801344668 | Arethea Tamara Moise | Nurse Practitioner | 1503 Buenos Aires Blvd, The Villages, FL 32159-6821 | 2016-09-21 |
| 1255711404 | Florida Cancer Specialists & Research Institute, LLC | Internal Medicine | 1503 Buenos Aires Blvd, Bldg 140, The Villages, FL 32159-6823 | 2015-06-03 |
| 1093107641 | Nicole Wharton | Physician Assistant | 1503 Buenos Aires Blvd, Bldg 100, The Villages, FL 32159-6821 | 2015-02-19 |
| 1790059640 | Alfredo Perlas Sy | Physician Assistant | 1503 Buenos Aires Blvd, Building 100, The Villages, FL 32159-6821 | 2012-02-23 |
| 1841578309 | Sheila Kreienbrink | Physician Assistant | 1503 Buenos Aires Blvd, The Villages, FL 32159-6821 | 2011-08-01 |
| 1821211335 | Rivers Family Medicine Pa | Family Medicine | 1503 Buenos Aires Blvd, Bldg 110, The Villages, FL 32159-6821 | 2007-04-11 |
| 1205928512 | Angel E Tafur Md Pa | Family Medicine | 1503 Buenos Aires Blvd, Building 160, The Villages, FL 32159-6821 | 2006-09-28 |
| 1821005141 | Patricia Lynn Cheston | Physician Assistant | 1503 Buenos Aires Blvd, 110, The Villages, FL 32159-6821 | 2006-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306451216 | Lindsey Porubcan | Physician Assistant | 990 South Us Highway 441/27, Lady Lake, FL 32159 | 2020-09-09 |
| 1073134979 | Michael Robert Frates | Dietitian, Registered | 900 Cr 466, Lady Lake, FL 32159 | 2020-05-01 |
| 1346800364 | Barbara Conrad | Social Worker | 906 Orchid Street, Lady Lake, FL 32159 | 2019-06-20 |
| 1962977165 | Curelogics Wound Care and Hyperbaric LLC | Registered Nurse | 809 County Road 466, Unit C-201, Lady Lake, FL 32159 | 2018-10-04 |
| 1346736907 | Caroline Butler | Physician Assistant | 805 E. Cr 466, Lady Lake, FL 32159 | 2018-07-06 |
| 1033609607 | Cyrus Immanuel Macalisang Doroy | Physical Therapist | 6340 County Rd 466, Suite 733, Lady Lake, FL 32159 | 2018-05-18 |
| 1962999680 | Sharma Institute of Pain Medicine | Physical Medicine & Rehabilitation | 1501 Us Hwy 441, Villages, FL 32159 | 2018-04-18 |
| 1538683198 | Cathleen Laurel Civiello | Psychologist | 929 H. Hwy 441, Suite 404, Lady Lake, FL 32159 | 2017-07-26 |
| 1649709015 | Adria Young | Optometrist | 801 Cr 466, Suite 102 Sunset Plaza, Lady Lake, FL 32159 | 2017-06-08 |
| 1891222527 | Center for Hope and Healing, LLC | Social Worker | 804 Hwy 466, Lady Lake, FL 32159 | 2017-05-12 |
| Find all providers in zip 32159 | ||||
| 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 | 32159 |
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.