Leavitt Medical Associates Of Florida Inc | |
2116 S Orange Ave Ste C Orlando FL 32806-3037 | |
(407) 770-0139 | |
(407) 770-0182 |
Full Name | Leavitt Medical Associates Of Florida Inc |
---|---|
Speciality | Dermatology |
Location | 2116 S Orange Ave, Orlando, 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 151 Southhall Ln Ste 300 Maitland FL 32751-7176 Ph: (407) 875-2080 | Leavitt Medical Associates Of Florida Inc 2116 S Orange Ave Ste C Orlando FL 32806-3037 Ph: (407) 770-0139 |
NPI Number | 1316105885 |
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Provider Enumeration Date | 05/30/2008 |
Last Update Date | 05/28/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316105885 | NPI | - | NPPES |
256877223 | 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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