| Leavitt Medical Associates Of Florida Inc | |
|
903 N Central Ave Kissimmee FL 34741-5029 | |
| (407) 705-5100 | |
| (407) 705-5104 |
| Full Name | Leavitt Medical Associates Of Florida Inc |
|---|---|
| Speciality | Dermatology |
| Location | 903 N Central Ave, Kissimmee, Florida |
| Authorized Official Name and Position | Amy Declue (DIRECTOR, PROVIDER SERVICES) |
| Authorized Official Contact | 4078752080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leavitt Medical Associates Of Florida Inc 2600 Lake Lucien Dr Ste 180 Maitland FL 32751-7235 Ph: (407) 875-2080 | Leavitt Medical Associates Of Florida Inc 903 N Central Ave Kissimmee FL 34741-5029 Ph: (407) 705-5100 |
| NPI Number | 1710145289 |
|---|---|
| Provider Enumeration Date | 05/30/2008 |
| Last Update Date | 04/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710145289 | NPI | - | NPPES |
| 256877224 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208200000X | Plastic Surgery | (* (Not Available)) | Secondary |
| 207N00000X | Dermatology | (* (Not Available)) | Primary |
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