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ADVANCED DERMATOLOGY AND COSMETIC SURGERY
NPI 1629212519
Dermatology in Miramar, FL

Active since April 23, 2009CLIA 10D1047602 · Waiver
12600 PEMBROKE RD, SUITE 312, MIRAMAR, FL 33027(954) 431-7681(954) 431-7682 Get Directions Write a Review

NPPES record last updated: June 4, 2013. 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 1629212519) is a healthcare organization registered as a dermatology in Miramar, Florida and active in the NPI registry since April 2009. The organization holds a CLIA Waiver certificate valid through May 10, 2027 and lists Nefrita Logan, Provider Service, as its authorized official.

NPPES Registry Identity

NPI1629212519
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Location Address12600 PEMBROKE RD, SUITE 312Miramar, FL 33027-2544
Mailing Address151 Southhall Ln, Suite 300Maitland, FL 32751-7176 · (407) 875-2080 · Fax (407) 875-0518
Phone(954) 431-7681
Fax(954) 431-7682
Organization SubpartYes
Authorized OfficialNefrita LoganProvider Service · (407) 875-2080
Enumeration DateApril 23, 2009
Last NPPES UpdateJune 4, 2013
✔ NPI 1629212519 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
12600 PEMBROKE RD, Miramar, FL 33027
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Other Names 1

Doing Business AsAdvanced Dermatology And Cosmetic Surgery

Other Identifiers 1

Medicare PIN98046BFL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 ›

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, 1 practice at this address and 2 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
Nicole Swenson, D.O.
Dermatology
NPI 1275805921
3 SW 129TH AVE STE 200
Pembroke Pines, FL 33027
(866) 400-3376
✔ PECOS✔ Accepts MedicareSame address
Ashley Pardue Gomez, RN
Nurse Practitioner
NPI 1851705735
4060 SHERIDAN ST STE C
Hollywood, FL 33021
(954) 987-7512
✔ PECOS8.5 mi
Chava Lustig, DO
Dermatology
NPI 1326158866
290 INDIAN TRCE
Weston, FL 33326
(954) 908-3604
✔ PECOS✔ Accepts Medicare10 mi
Annyella Douglas
Dermatology
NPI 1619438348
3 SW 129TH AVE STE 100
Pembroke Pines, FL 33027
(866) 400-3376
✔ PECOS✔ Accepts Medicare10 mi
Nicky Gazy
Dermatology
NPI 1104311075
3 SW 129TH AVE STE 100
Pembroke Pines, FL 33027
(866) 400-3376
✔ PECOS✔ Accepts Medicare10 mi
Jay Gottlieb, DO
Dermatology
NPI 1588660757
3 SW 129TH AVE STE 100
Pembroke Pines, FL 33027
(866) 400-3376
✔ PECOS✔ Accepts Medicare10 mi
Danielle Dubin, MD
Dermatology
NPI 1285256305
3 SW 129TH AVE STE 100
Pembroke Pines, FL 33027
(866) 400-3376
✔ PECOS✔ Accepts Medicare10 mi
Mark Kaufmann, M.D.
Dermatology
NPI 1386648616
3 SW 129TH AVE STE 100
Pembroke Pines, FL 33027
(866) 400-3376
✔ PECOS✔ Accepts Medicare10 mi
Scott Podnos, MD
Dermatology
NPI 1053421446
290 INDIAN TRCE
Weston, FL 33326
(954) 908-3604
✔ PECOS✔ Accepts Medicare11 mi
Martin Schiff, MD
Dermatology
NPI 1659336832
3000 UNIVERSITY DR STE K
Coral Springs, FL 33065
(954) 752-2630
✔ PECOS✔ Accepts Medicare19 mi
William Mcdonald, MD
Plastic and Reconstructive Surgery
NPI 1356307979
8740 N KENDALL DR STE 101
Miami, FL 33176
(305) 381-8900
✔ PECOS✔ Accepts Medicare23 mi
Patricia Klem, D.O.
Dermatology
NPI 1164626545
1905 CLINT MOORE RD. STE. 103 ADVANCED DERMATOLOGY
Boca Raton, FL 33496
(561) 241-5858
✔ PECOS✔ Accepts Medicare31 mi
Liliana Montoya, M.D.
Dermatology
NPI 1669861407
1905 CLINT MOORE RD STE 103
Boca Raton, FL 33496
(866) 400-3376
✔ PECOS✔ Accepts Medicare31 mi
Robin Burger
Pathology
NPI 1588058648
1300 NW 17TH AVE STE 130
Delray Beach, FL 33445
(561) 819-0857
✔ PECOS✔ Accepts Medicare36 mi
Shuo Liu, MD; PHD
Pathology
NPI 1336644590
1300 NW 17TH AVE
Delray Beach, FL 33445
(773) 816-4522
✔ PECOS✔ Accepts Medicare36 mi
Etan Marks, D.O.
Pathology
NPI 1528301728
1300 NW 17TH AVE STE 130A
Delray Beach, FL 33445
(866) 400-3376
✔ PECOS✔ Accepts Medicare36 mi
Apphia Wang, MD
Dermatology
NPI 1902224553
1035 S STATE ROAD 7 STE 122
Wellington, FL 33414
(650) 353-6377
✔ PECOS✔ Accepts Medicare53 mi
Edmundo Barreto, APRN
Nurse Practitioner
NPI 1346909421
615 WILLIAMS AVE
Lehigh Acres, FL 33972
(239) 310-5269
✔ PECOS✔ Accepts Medicare93 mi
Timothy Lian, M.D.
Otolaryngology
NPI 1154355493
11181 HEALTH PARK BLVD STE 2280
Naples, FL 34110
(239) 594-9075
✔ PECOS✔ Accepts Medicare94 mi
Christina Morales, APRN
Nurse Practitioner
NPI 1285295139
16461 DOMESTIC AVENUE
Fort Myers, FL 33912
(772) 667-7688
✔ PECOS✔ Accepts Medicare100 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 Waiver 10D1047602

Advanced Dermatology And Cosmetic Surgery · Pembroke Pines, FL
Active · expires May 10, 2027
CLIA Number10D1047602
Laboratory TypePhysician Office
Certificate Effective DateMay 11, 2025
Certificate Expiration DateMay 10, 2027
Laboratory DirectorJay S. Gottlieb
Laboratory Phone(407) 284-3407
Laboratory LocationAdvanced Dermatology And Cosmetic Surgery3 SW 129th Avenue Ste 100, Pembroke Pines, FL 33027
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only 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 1629212519. It was assigned to this organization in the NPPES registry on April 23, 2009. 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 12600 Pembroke Rd Suite 312, Miramar, FL 33027. The listed phone number is (954) 431-7681.

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, 1 practice at this address and 2 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 of Waiver (number 10D1047602) is associated with this NPI, valid through May 10, 2027. 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 June 4, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.