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ADVANCED DERMATOLOGY AND COSMETIC SURGERY
NPI 1316105885
Dermatology in Orlando, FL

Active since May 30, 2008CLIA 10D1055363 · Microscopy
2116 S ORANGE AVE, STE C, ORLANDO, FL 32806(407) 770-0139(407) 770-0182 Get Directions Write a Review

NPPES record last updated: May 28, 2014. Verified against the NPPES registry weekly; last sync: August 09, 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 1316105885) is a healthcare organization registered as a dermatology in Orlando, Florida and active in the NPI registry since May 2008. The organization holds a CLIA Microscopy certificate valid through April 27, 2028 and lists Amy Declue, Director, Provider Services, as its authorized official.

NPPES Registry Identity

NPI1316105885
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Location Address2116 S ORANGE AVE, STE COrlando, FL 32806-3037
Mailing Address151 Southhall Ln, Ste 300Maitland, FL 32751-7176 · (407) 875-2080 · Fax (407) 650-3455
Phone(407) 770-0139
Fax(407) 770-0182
Organization SubpartYes
Authorized OfficialAmy DeclueDirector, Provider Services · (407) 875-2080
Enumeration DateMay 30, 2008
Last NPPES UpdateMay 28, 2014
✔ NPI 1316105885 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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 ListedFamily MedicineTaxonomy 207Q00000X
Also ListedPlastic SurgeryTaxonomy 208200000X
2116 S ORANGE AVE, Orlando, FL 32806
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Other Names 1

Doing Business AsAdvanced Dermatology And Cosmetic Surgery

Other Identifiers 2

Medicaid256877223FL
Medicare PIN98046HFL

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

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

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 for Provider-Performed Microscopy Procedures (PPMP) 10D1055363

Advanced Dermatology And Cosmetic Surgery · Orlando, FL
Active · expires Apr 27, 2028
CLIA Number10D1055363
Laboratory TypePhysician Office
Certificate Effective DateApril 28, 2026
Certificate Expiration DateApril 27, 2028
Laboratory DirectorPatrick Dominguez
Laboratory Phone(407) 284-3407
Laboratory LocationAdvanced Dermatology And Cosmetic Surgery80 W Grant Street Ste 117, Orlando, FL 32806
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KENT CLINIC, LLC
Physical Medicine & Rehabilitation (Pain Medicine)
2116 S ORANGE AVE, SUITE B
ORLANDO, FL 32806
Orange County (407) 704-8990
SADI A ABUSRUR MD PLLC
Anesthesiology
2116 S ORANGE AVE, SUITE B
ORLANDO, FL 32806
Orange County (407) 704-8990
DR. SHIRIN ESMAIL RAWJI DDS
Dentist (General Practice)
2116 S ORANGE AVE
ORLANDO, FL 32806
Orange County (407) 426-9933
CINERGY PHARMACY LLC
Pharmacy (Community/Retail Pharmacy)
2116 S ORANGE AVE, SUITE B
ORLANDO, FL 32806
Orange County (407) 757-0567
MATEEN SHEIKH D.M.D.
Dentist (General Practice)
2116 S ORANGE AVE
ORLANDO, FL 32806
Orange County (407) 426-9933

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 1316105885. 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 2116 S Orange Ave Ste C, Orlando, FL 32806. The listed phone number is (407) 770-0139.

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

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

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

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 10D1055363) is associated with this NPI, valid through April 27, 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 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 May 28, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.