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ADVANCED DERMATOLOGY AND COSMETIC SURGERY
NPI 1902067671
Dermatology in Palm Coast, FL

Active since June 24, 2008CLIA Certified · 2 labs
3 PINE CONE DR, SUITE 102, PALM COAST, FL 32137(888) 540-9660(407) 875-0518 Get Directions Write a Review

NPPES record last updated: April 21, 2010. Verified against the NPPES registry weekly; last sync: August 16, 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 1902067671) is a healthcare organization registered as a dermatology in Palm Coast, Florida and active in the NPI registry since June 2008. The organization holds 2 active CLIA laboratory certificates and lists Amy Declue, Director, Provider Services, as its authorized official.

NPPES Registry Identity

NPI1902067671
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Location Address3 PINE CONE DR, SUITE 102Palm Coast, FL 32137-8685
Mailing Address2600 Lake Lucien Dr Ste 180Maitland, FL 32751-7235 · (407) 875-2080 · Fax (407) 875-0518
Phone(888) 540-9660
Fax(407) 875-0518
Organization SubpartYes
Authorized OfficialAmy DeclueDirector, Provider Services · (407) 875-2080
Enumeration DateJune 24, 2008
Last NPPES UpdateApril 21, 2010
✔ NPI 1902067671 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
3 PINE CONE DR, Palm Coast, FL 32137
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Other Names 1

Doing Business AsAdvanced Dermatology And Cosmetic Surgery

Other Identifiers 1

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 2

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) 10D2157867

Advanced Dermatology And Cosmetic Surgery · Palm Coast, FL
Active · expires Apr 30, 2027
CLIA Number10D2157867
Laboratory TypePhysician Office
Certificate Effective DateMay 1, 2025
Certificate Expiration DateApril 30, 2027
Laboratory DirectorStephen Eubanks
Laboratory Phone(407) 284-3407
Laboratory LocationAdvanced Dermatology And Cosmetic Surgery3 Pine Cone Dr Ste 102, Palm Coast, FL 32137
CLIA data matches this NPI record on: Address 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.

Certificate of Accreditation 10D2155365

Advanced Dermatology And Cosmetic Surgery · Palm Coast, FL
Active · expires Feb 26, 2028
CLIA Number10D2155365
Laboratory TypePhysician Office
Certificate Effective DateFebruary 27, 2026
Certificate Expiration DateFebruary 26, 2028
Laboratory DirectorRafael Schulze
Laboratory Phone(407) 284-3407
Laboratory LocationAdvanced Dermatology And Cosmetic Surgery8 Office Park Drive Suite A, Palm Coast, FL 32137
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 8

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

ROBERT J WRABLE DMD
Dentist (General Practice)
3 PINE CONE DR, SUITE 108
PALM COAST, FL 32137
Flagler County (386) 447-6550
FIRST COAST PULMONARY ASSOCIATES
Family Medicine
3 PINE CONE DR, SUITE # 106
PALM COAST, FL 32137
Flagler County (386) 986-1422
DR. CHRISTINE LAURA BURKE OD
Optometrist
3 PINE CONE DR
PALM COAST, FL 32137
Flagler County (386) 446-9590
EAST CENTRAL FLORIDA OUTPATIENT IMAGING, LLC
Radiology (Diagnostic Radiology)
3 PINE CONE DR, SUITE 101
PALM COAST, FL 32137
Flagler County (386) 446-5200
ADVANCED DENTAL CARE PALM COAST
Dentist
3 PINE CONE DR
PALM COAST, FL 32137
Flagler County (386) 447-6550
FREDERICK A FOX DDS
Dentist
3 PINE CONE DR, SUITE 108
PALM COAST, FL 32137
Flagler County (386) 445-6550
OCEANS DENTAL GROUP INC
Denturist
3 PINE CONE DR, SUITE 108
PALM COAST, FL 32137
Flagler County (386) 447-6550
ALEXANDRA KOSTICK MD PA
Ophthalmology
3 PINE CONE DR, SUITE 104
PALM COAST, FL 32137
Flagler County (386) 446-9590

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 1902067671. It was assigned to this organization in the NPPES registry on June 24, 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 3 Pine Cone Dr Suite 102, Palm Coast, FL 32137. The listed phone number is (888) 540-9660.

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 CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

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.