Individual
MRS. AMALIA LEAVITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8814 FOREST LAKE DR, PORT RICHEY, FL 34668-5819
(813) 453-8110
Mailing address
8814 FOREST LAKE DR, PORT RICHEY, FL 34668-5819
(813) 453-8110
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
687794096
—
FL
Enumeration date
06/09/2008
Last updated
07/21/2008
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