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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: October 25, 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 Cigna Healthcare, Cigna HealthCare of Florida, Inc., Florida Blue (BlueCross BlueShield FL) and more.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, 6 practice within 10 miles. 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
Patrick Dominguez, M.D.
Dermatology
NPI 1184891830
80 W GRANT ST STE 117
Orlando, FL 32806
(866) 400-3376
✔ PECOS✔ Accepts Medicare0.2 mi
Shreyal Patel
Nurse Practitioner
NPI 1992381198
151 SOUTHHALL LN STE 300
Maitland, FL 32751
(407) 875-2080
✔ PECOS✔ Accepts Medicare7.7 mi
Rajiv Nathoo, MD
Dermatology
NPI 1588002059
430 LAKE HOWELL RD
Maitland, FL 32751
(407) 636-3113
✔ PECOS✔ Accepts Medicare8.2 mi
Matt Leavitt, DO
Dermatology
NPI 1821108341
260 LOOKOUT PL STE 103
Maitland, FL 32751
(407) 373-0700
✔ PECOS✔ Accepts Medicare8.3 mi
Savina Aneja
Dermatology
NPI 1184985996
9368 NARCOOSSEE RD STE 104
Orlando, FL 32827
(407) 745-1966
✔ PECOS✔ Accepts Medicare9.5 mi
Sadia Saeed, MD
Dermatology
NPI 1518169556
745 ORIENTA AVE SUITE 1201
Altamonte Springs, FL 32701
(800) 226-8968
✔ PECOS✔ Accepts Medicare9.9 mi
Adam Leavitt, M.D.
Dermatology
NPI 1720519226
2915 LAKEVIEW DR STE 32730
Fern Park, FL 32730
(407) 834-9091
✔ PECOS✔ Accepts Medicare10 mi
Adrianna Mills
Nurse Practitioner
NPI 1962022798
2915 LAKEVIEW DR STE 2021
Fern Park, FL 32730
(866) 400-3376
✔ PECOS✔ Accepts Medicare10 mi
Dilan Ipek
Nurse Practitioner
NPI 1952188633
4970 S US HIGHWAY 17/92
Casselberry, FL 32707
(407) 635-8012
✔ PECOS✔ Accepts Medicare11 mi
Valenie Rivera Roig, M.D.
Dermatology
NPI 1295784957
14050 TOWN LOOP BLVD SUITE 203
Orlando, FL 32837
(407) 852-6650
✔ PECOS✔ Accepts Medicare11 mi
Zackary Whitney, DO
Dermatology
NPI 1942763941
409 SUMMIT RIDGE PL APT 107
Longwood, FL 32779
(435) 215-6012
✔ PECOS✔ Accepts Medicare13 mi
Jason Kieffer, MD
Dermatology
NPI 1215277454
1410 W BROADWAY ST STE 205
Oviedo, FL 32765
(866) 400-3376
✔ PECOS✔ Accepts Medicare14 mi
Jere Mammino, DO
Dermatology
NPI 1336259886
1410 W BROADWAY ST STE 102
Oviedo, FL 32765
(407) 359-2100
✔ PECOS✔ Accepts Medicare14 mi
Nicole Cabbad, M.D., M.B.A.
Plastic and Reconstructive Surgery
NPI 1306133004
120 INTERNATIONAL PKWY
Lake Mary, FL 32746
(866) 400-3376
✔ PECOS✔ Accepts Medicare17 mi
Lauren Leavitt, PA
Physician Assistant
NPI 1457789307
120 INTERNATIONAL PARKWAY SUITE 300
Heathrow, FL 32746
(407) 333-4200
✔ PECOS✔ Accepts Medicare17 mi
Panagiotis Mitropoulos, DO
Dermatology
NPI 1538283502
120 INTERNATIONAL PKWY STE 240
Heathrow, FL 32746
(407) 333-4200
✔ PECOS✔ Accepts Medicare17 mi
Michael Burton, M.D.
Plastic and Reconstructive Surgery
NPI 1184850018
120 INTERNATIONAL PKWY SUITE 240
Heathrow, FL 32746
(407) 333-4200
✔ PECOS✔ Accepts Medicare17 mi
Julie Goldstein
Nurse Practitioner
NPI 1275176042
15222 BOOK CLUB RD
Winter Garden, FL 34787
(954) 214-1167
✔ PECOS✔ Accepts Medicare18 mi
Mandy Moore, ARNP
Nurse Practitioner
NPI 1396168118
1920 DON WICKHAM DRIVE SUIT 330
Clermont, FL 34711
(352) 241-4298
✔ PECOS✔ Accepts Medicare21 mi
Maria Moreno Cabasos, NP
Nurse Practitioner
NPI 1780148346
1920 DON WICKHAM DR
Clermont, FL 34711
(866) 400-3376
✔ PECOS✔ Accepts Medicare21 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 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.

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.

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, 6 practice within 10 miles. 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 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 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 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.