ADVANCED DERMATOLOGY AND COSMETIC SURGERY
NPI 1528097284
Dermatology in Heathrow, FL

NPI Status: Active since July 02, 2006

Contact Information

120 INTERNATIONAL PKWY
240
HEATHROW, FL
ZIP 32746
Phone: (407) 333-4200
Fax: (407) 829-6637

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  • Organization
  • Dermatology
  • Accepts Insurance
  • CLIA Number: 10D0973519
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 06-23-2026

About ADVANCED DERMATOLOGY AND COSMETIC SURGERY

This page provides the complete NPI Profile along with additional information for Advanced Dermatology And Cosmetic Surgery, a provider established in Heathrow, Florida operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1528097284 assigned on July 2006. The practitioner's primary taxonomy code is 207N00000X with license number OS5365 (FL). The provider is registered as an organization and their NPI record was last updated 9 years ago. Advanced Dermatology And Cosmetic Surgery operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Advanced Dermatology And Cosmetic Surgery. The authorized official of this NPI record is Amy Declue (Director Of Provider Services)

NPI
1528097284
Provider Legal Name
LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Other Organization Name
ADVANCED DERMATOLOGY AND COSMETIC SURGERY
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
120 INTERNATIONAL PKWY 240 HEATHROW, FL 32746
Location Phone
(407) 333-4200
Location Fax
(407) 829-6637
Mailing Address
151 SOUTHHALL LN STE 300 MAITLAND, FL 32751
Mailing Phone
(407) 875-2080
Mailing Fax
(407) 829-6637
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-02-2006
Last Update Date
08-29-2017
Code Navigator

A dermatologist like Advanced Dermatology And Cosmetic Surgery is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dermatology

Taxonomy Code
207N00000X
Type
Allopathic & Osteopathic Physicians
License No.
OS5365
License State
FL
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207ND0101XAllopathic & Osteopathic Physicians

Dermatology
MOHS-Micrographic Surgery

OS5365 (FL)
2207ND0900XAllopathic & Osteopathic Physicians

Dermatology
Dermatopathology

OS5365 (FL)
3207NP0225XAllopathic & Osteopathic Physicians

Dermatology
Pediatric Dermatology

OS5365 (FL)
4207NS0135XAllopathic & Osteopathic Physicians

Dermatology
Procedural Dermatology

OS5365 (FL)
5207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

OS5365 (FL)
6207RA0201XAllopathic & Osteopathic Physicians

Internal Medicine
Allergy & Immunology

OS5365 (FL)
7208200000XAllopathic & Osteopathic Physicians

Plastic Surgery

OS5365 (FL)
8208600000XAllopathic & Osteopathic Physicians

Surgery

OS5365 (FL)

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete VALUE Gold - HMO
  • Focused VALUE Silver - HMO
  • Focused VALUE Silver + Vision + Adult Dental - HMO
  • Standard Gold VALUE - HMO
  • Standard Silver VALUE - HMO
  • Standard Silver VALUE + Vision + Adult Dental - HMO
  • Clarity Silver - HMO
  • Clarity VALUE Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete VALUE Gold - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite VALUE Bronze - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Focused VALUE Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze VALUE - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • AvMed Entrust Bronze 600 (2026) - HMO
  • AvMed Entrust Bronze 650 (2026) - HMO
  • AvMed Entrust Expanded Bronze Standard (2026) - HMO
  • AvMed Entrust Gold 125 (2026) - HMO
  • AvMed Entrust Gold 125 Dental+Vision (2026) - HMO
  • AvMed Entrust Gold Standard (2026) - HMO
  • AvMed Entrust Platinum 25 (2026) - HMO
  • AvMed Entrust Platinum 25 Dental+Vision (2026) - HMO
  • AvMed Entrust Platinum Standard (2026) - HMO
  • AvMed Entrust Silver 350 (2026) - HMO
  • AvMed Entrust Silver 350 Dental+Vision (2026) - HMO
  • AvMed Entrust Silver 550 (2026) - HMO
  • AvMed Entrust Silver 550 Dental+Vision (2026) - HMO
  • AvMed Entrust Silver Standard (2026) - HMO
  • BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
  • BlueOptions Bronze 24J01-04 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-06 (Rewards) - PPO
  • BlueOptions Bronze 24J01-17 ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-18S ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Gold 24J01-09 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-12 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-20S ($30 PCP Visits / $60 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-05 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-08 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - PPO
  • BlueOptions Silver 24J01-03 ($10 Labs / Rewards) - PPO
  • BlueOptions Silver 24J01-07 ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Silver 24J01-19S ($40 PCP Visits / $80 Specialist Visits / Rewards) - PPO
  • myBlue Bronze 1601 (3 PCP Visits for $0 then $25 / $75 Specialist Visits / Rewards) - HMO
  • myBlue Bronze 2013 (3 PCP Visits for $0 then $5 / $75 Specialist Visits / Rewards) - HMO
  • myBlue Bronze 2129 ($35 PCP Visits / $75 Specialist Visits / Rewards) - HMO
  • myBlue Bronze 2129E ($35 PCP Visits / $75 Specialist Visits / Adult Dental & Vision / Rewards) - HMO
  • myBlue Bronze 2129V ($35 PCP Visits / $75 Specialist Visits / Adult Vision / Rewards) - HMO
  • myBlue Bronze 2149 ($35 PCP Visits / $75 Specialist Visits / Rewards) - HMO
  • myBlue Bronze 2149E ($35 PCP Visits / $75 Specialist Visits / Adult Dental & Vision / Rewards) - HMO
  • myBlue Bronze 2149V ($35 PCP Visits / $75 Specialist Visits / Adult Vision / Rewards) - HMO
  • myBlue Bronze 2219 ($75 PCP Visits / Rewards) - HMO
  • myBlue Bronze 2286 ($75 PCP Visits / Rewards) - HMO
  • myBlue Bronze 2312S ($50 PCP Visits / Rewards) - HMO
  • myBlue Bronze 2322S ($50 PCP Visits / Rewards) - HMO
  • myBlue Bronze 26M01-23 (Rewards) - HMO
  • myBlue Bronze 26M02-24 (Rewards) - HMO
  • myBlue Connected Care Silver 24M03-70 ($0 Primary Care Visits with Select Providers / Rewards) - HMO
  • myBlue Gold 1605 ($0 Labs / Rewards) - HMO
  • myBlue Gold 2011 ($0 Labs / Rewards) - HMO
  • myBlue Gold 2016 ($0 Deductible / $25 PCP Visits / $60 Specialist Visits / Rewards) - HMO
  • myBlue Gold 2314S ($30 PCP Visits / $60 Specialist Visits / Rewards) - HMO
  • myBlue Gold 2325S ($30 PCP Visits / $60 Specialist Visits / Rewards) - HMO
  • Molina Bronze Enhanced 3500 - HMO
  • Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision - HMO
  • Molina Bronze Enhanced 3500 Plus with Adult Vision - HMO
  • Molina Bronze Premier with $0 Medical Deductible - HMO
  • Molina Bronze Premier with $0 Medical Deductible Plus with Adult Dental and Vision - HMO
  • Molina Bronze Premier with $0 Medical Deductible Plus with Adult Vision - HMO
  • Molina Bronze Standard - HMO
  • Molina Gold Core 1640 - HMO
  • Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
  • Molina Gold Core 1640 Plus with Adult Vision - HMO
  • Molina Gold Enhanced 895 - HMO
  • Molina Gold Enhanced 895 Plus with Adult Dental and Vision - HMO
  • Molina Gold Enhanced 895 Plus with Adult Vision - HMO
  • Molina Gold Standard - HMO
  • Molina Silver Access - HMO
  • Molina Silver Access Plus with Adult Dental and Vision - HMO
  • Molina Silver Access Plus with Adult Vision - HMO
  • Molina Silver Core - HMO
  • Molina Silver Core Plus with Adult Dental and Vision - HMO
  • Molina Silver Core Plus with Adult Vision - HMO
  • Wellpoint Essential Bronze 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Bronze 5500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Bronze 7500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
  • Wellpoint Essential Catastrophic (+ Incentives) - HMO
  • Wellpoint Essential Gold 1400 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold 2000 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
  • Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold 800 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

AMY DECLUE

Authorized Official Title
DIRECTOR OF PROVIDER SERVICES
Authorized Official Phone
(407) 875-2080

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
98046BMEDICARE PIN (08)FL 
98046HMEDICARE PIN (08)FL 
256877200MEDICAID (05)FL 
98046MEDICARE PIN (08)FL 
98046AMEDICARE PIN (08)FL 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
10D0973519
Facility Type
Physician Office
Certificate Effective Date
June 24, 2024
Certificate Expiration Date
June 23, 2026
Laboratory Director
RAFAEL SCHULZE
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Advanced Dermatology And Cosmetic Surgery on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1528097284, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
2
Doubled → 4
Pos 4
8
Unchanged
Pos 5
0
Doubled → 0
Pos 6
9
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
2
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 0 → 0 7 → 14 → 5 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 4 + 8 + 0 + 9 + 1 + 4 + 2 + 1 + 6 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1528097284.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Dentist
120 INTERNATIONAL PKWY, SUITE #264
HEATHROW, FL 32746
Chiropractor
120 INTERNATIONAL PKWY, SUITE 124
LAKE MARY, FL 32746
Case Management
120 INTERNATIONAL PKWY, SUITE 220
LAKE MARY, FL 32746
Registered Nurse (Case Management)
120 INTERNATIONAL PKWY, SUITE 220
LAKE MARY, FL 32746
Surgery (Plastic and Reconstructive Surgery)
120 INTERNATIONAL PKWY, SUITE 240
HEATHROW, FL 32746
Point of Service
120 INTERNATIONAL PKWY, SUITE 220
LAKE MARY, FL 32746
Plastic Surgery
120 INTERNATIONAL PKWY
LAKE MARY, FL 32746

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1528097284, enumerated as an "organization" on July 02, 2006.

The provider is located at 120 INTERNATIONAL PKWY 240 HEATHROW, FL 32746 and the phone number is (407) 333-4200.

Dermatology with taxonomy code 207N00000X.

The provider might be accepting Accepts: Ambetter from Superior HealthPlan, Ambetter. Please consult your insurance carrier or call the provider to verify.