ADVANCED DERMATOLOGY AND COSMETIC SURGERY
NPI 1144488628
Dermatology in Clermont, FL

Active since May 30, 2008CLIA 10D1036755 · Accreditation
1920 DON WICKHAM DR, SUITE 330, CLERMONT, FL 34711(352) 241-4298(352) 241-7620 Get Directions Write a Review

NPPES record last updated: August 25, 2010. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Advanced Dermatology And Cosmetic Surgery NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADVANCED DERMATOLOGY AND COSMETIC SURGERY (NPI 1144488628) is a healthcare organization registered as a dermatology in Clermont, Florida and active in the NPI registry since May 2008. The organization holds an CLIA Accreditation certificate valid through June 23, 2028 and lists Amy Declue, Director, Provider Services, as its authorized official.

NPPES Registry Identity

NPI1144488628
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Location Address1920 DON WICKHAM DR, SUITE 330Clermont, FL 34711-1918
Mailing Address2600 Lake Lucien Dr Ste 180Maitland, FL 32751-7235 · (407) 875-2080 · Fax (407) 875-0518
Fax(352) 241-7620
Organization SubpartYes
Authorized OfficialAmy DeclueDirector, Provider Services · (407) 875-2080
Enumeration DateMay 30, 2008
Last NPPES UpdateAugust 25, 2010
✔ NPI 1144488628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
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.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedDermatology · Pediatric DermatologyTaxonomy 207NP0225X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedPlastic SurgeryTaxonomy 208200000X
1920 DON WICKHAM DR, Clermont, FL 34711

Other Names 1

Doing Business AsAdvanced Dermatology And Cosmetic Surgery

Other Identifiers 2

Medicaid256877219FL
Medicare PIN98046FL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Advanced Dermatology And Cosmetic Surgery is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

115

Medicare enrollment records show 115 clinicians reassign Medicare billing to Advanced Dermatology And Cosmetic Surgery, which bills Medicare for the services they deliver. Of these, 3 practice at this address. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 7

Dermatology63
Nurse Practitioner35
Plastic and Reconstructive Surgery8
Pathology5
Micrographic Dermatologic Surgery (MDS)2
Otolaryngology1
Physician Assistant1

Nearest to this location (20)

See all 115
Nurse Practitioner
NPI 1780148346
1920 DON WICKHAM DR
Clermont, FL 34711
(866) 400-3376
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1396168118
1920 DON WICKHAM DRIVE SUIT 330
Clermont, FL 34711
(352) 241-4298
✔ PECOS✔ Accepts MedicareSame address
Dermatology
NPI 1447593686
1920 DON WICKHAM DR STE 330
Clermont, FL 34711
(352) 241-4298
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1275176042
15222 BOOK CLUB RD
Winter Garden, FL 34787
(954) 214-1167
✔ PECOS✔ Accepts Medicare12 mi
Nurse Practitioner
NPI 1437600707
1816 SALK AVE
Tavares, FL 32778
(352) 343-2461
✔ PECOS✔ Accepts Medicare18 mi
Nurse Practitioner
NPI 1992381198
151 SOUTHHALL LN STE 300
Maitland, FL 32751
(407) 875-2080
✔ PECOS✔ Accepts Medicare20 mi
Dermatology
NPI 1184891830
80 W GRANT ST STE 117
Orlando, FL 32806
(866) 400-3376
✔ PECOS✔ Accepts Medicare21 mi
Dermatology
NPI 1942763941
409 SUMMIT RIDGE PL APT 107
Longwood, FL 32779
(435) 215-6012
✔ PECOS✔ Accepts Medicare22 mi
Dermatology
NPI 1821108341
260 LOOKOUT PL STE 103
Maitland, FL 32751
(407) 373-0700
✔ PECOS✔ Accepts Medicare22 mi
Dermatology
NPI 1295784957
14050 TOWN LOOP BLVD SUITE 203
Orlando, FL 32837
(407) 852-6650
✔ PECOS✔ Accepts Medicare23 mi
Dermatology
NPI 1518169556
745 ORIENTA AVE SUITE 1201
Altamonte Springs, FL 32701
(800) 226-8968
✔ PECOS✔ Accepts Medicare23 mi
Dermatology
NPI 1720519226
2915 LAKEVIEW DR STE 32730
Fern Park, FL 32730
(407) 834-9091
✔ PECOS✔ Accepts Medicare24 mi
Nurse Practitioner
NPI 1962022798
2915 LAKEVIEW DR STE 2021
Fern Park, FL 32730
(866) 400-3376
✔ PECOS✔ Accepts Medicare24 mi
Nurse Practitioner
NPI 1952188633
4970 S US HIGHWAY 17/92
Casselberry, FL 32707
(407) 635-8012
✔ PECOS✔ Accepts Medicare24 mi
Dermatology
NPI 1588002059
430 LAKE HOWELL RD
Maitland, FL 32751
(407) 636-3113
✔ PECOS✔ Accepts Medicare25 mi
Plastic and Reconstructive Surgery
NPI 1184850018
120 INTERNATIONAL PKWY SUITE 240
Heathrow, FL 32746
(407) 333-4200
✔ PECOS✔ Accepts Medicare26 mi
Dermatology
NPI 1538283502
120 INTERNATIONAL PKWY STE 240
Heathrow, FL 32746
(407) 333-4200
✔ PECOS✔ Accepts Medicare26 mi
Physician Assistant
NPI 1457789307
120 INTERNATIONAL PARKWAY SUITE 300
Heathrow, FL 32746
(407) 333-4200
✔ PECOS✔ Accepts Medicare26 mi
Nurse Practitioner
NPI 1346818937
340 HEALD WAY STE 238
The Villages, FL 32163
(866) 400-3376
✔ PECOS✔ Accepts Medicare26 mi
Micrographic Dermatologic Surgery (MDS)
NPI 1407218308
540 MEDICAL OAKS AVE STE 102
Brandon, FL 33511
(813) 692-4171
✔ PECOS✔ Accepts Medicare55 mi
See all 115 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 10D1036755

Advanced Dermatology And Cosmetic Surgery · Clermont, FL
Active · expires Jun 23, 2028
CLIA Number10D1036755
Laboratory TypePhysician Office
Certificate Effective DateJune 24, 2026
Certificate Expiration DateJune 23, 2028
Laboratory DirectorRafael A. Schulze
Laboratory Phone(352) 241-4298
Laboratory LocationAdvanced Dermatology And Cosmetic Surgery2757 Citrus Tower Blvd Suite 201, Clermont, FL 34711
CLIA data matches this NPI record on: Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leavitt Medical Associates Of Florida Inc's NPI number?

The NPI number for Leavitt Medical Associates Of Florida Inc is 1144488628. It was assigned to this organization in the NPPES registry on May 30, 2008. The provider is doing business as Advanced Dermatology And Cosmetic Surgery.

Where is Leavitt Medical Associates Of Florida Inc located?

Leavitt Medical Associates Of Florida Inc is located at 1920 Don Wickham Dr Suite 330, Clermont, FL 34711. The listed phone number is (352) 241-4298.

What is Leavitt Medical Associates Of Florida Inc's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Leavitt Medical Associates Of Florida Inc enrolled in Medicare?

Yes. Leavitt Medical Associates Of Florida Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Leavitt Medical Associates Of Florida Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 115 clinicians in 7 Medicare specialties reassign their Medicare billing to Leavitt Medical Associates Of Florida Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dermatology (63), Nurse Practitioner (35) and Plastic and Reconstructive Surgery (8). Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Leavitt Medical Associates Of Florida Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 10D1036755) is associated with this NPI, valid through June 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Leavitt Medical Associates Of Florida Inc accept?

Health plans from Cigna HealthCare of Florida, Inc., Cigna Healthcare, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Leavitt Medical Associates Of Florida Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Leavitt Medical Associates Of Florida Inc was last updated on August 25, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.