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ADVANCED DERMATOLOGY AND COSMETIC SURGERY
NPI 1679731178
Dermatology in St Petersburg, FL

Active since May 30, 2008CLIA 10D1070337 · Waiver
6450 38TH AVE N STE 420, ST PETERSBURG, FL 33710(727) 344-6851(727) 345-4716 Get Directions Write a Review

NPPES record last updated: April 21, 2010. Verified against the NPPES registry weekly; last sync: August 02, 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 1679731178) is a healthcare organization registered as a dermatology in St Petersburg, Florida and active in the NPI registry since May 2008. The organization holds a CLIA Waiver certificate valid through November 30, 2027 and lists Amy Declue, Director, Provider Services, as its authorized official.

NPPES Registry Identity

NPI1679731178
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Location Address6450 38TH AVE N STE 420St Petersburg, FL 33710-1653
Mailing Address2600 Lake Lucien Dr Ste 180Maitland, FL 32751-7235 · (407) 875-2080 · Fax (407) 875-0518
Phone(727) 344-6851
Fax(727) 345-4716
Organization SubpartYes
Authorized OfficialAmy DeclueDirector, Provider Services · (407) 875-2080
Enumeration DateMay 30, 2008
Last NPPES UpdateApril 21, 2010
✔ NPI 1679731178 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 ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedPlastic SurgeryTaxonomy 208200000X
6450 38TH AVE N STE 420, St Petersburg, FL 33710
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Other Names 1

Doing Business AsAdvanced Dermatology And Cosmetic Surgery

Other Identifiers 2

Medicaid256877211FL
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

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 of Waiver 10D1070337

Advanced Dermatology And Cosmetic Surgery · Saint Petersburg, FL
Active · expires Nov 30, 2027
CLIA Number10D1070337
Laboratory TypePhysician Office
Certificate Effective DateDecember 1, 2025
Certificate Expiration DateNovember 30, 2027
Laboratory DirectorMaria Garcia-Cardona
Laboratory Phone(407) 284-3407
Laboratory LocationAdvanced Dermatology And Cosmetic Surgery6450 38th Ave N - Ste 420, Saint Petersburg, FL 33710
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

MINDY LEY ROMANOV PA
Physician Assistant
6450 38TH AVE N STE 420
ST PETERSBURG, FL 33710
Pinellas County (727) 344-6851
SONYA UNNOPPET PA
Physician Assistant
6450 38TH AVE N STE 420
ST PETERSBURG, FL 33710
Pinellas County (727) 344-6851
CAYLA KRISTINE SMITH
Physician Assistant
6450 38TH AVE N STE 420
ST PETERSBURG, FL 33710
Pinellas County (866) 400-3376
MS. SOPHIE EUSEBIO-PEREA ARNP
Nurse Practitioner (Family)
6450 38TH AVE N STE 420
ST PETERSBURG, FL 33710
Pinellas County (727) 344-6851

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 1679731178. 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 6450 38th Ave N Ste 420, St Petersburg, FL 33710. The listed phone number is (727) 344-6851.

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 of Waiver (number 10D1070337) is associated with this NPI, valid through November 30, 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 April 21, 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.