Organization
LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Active
Parent organization
LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Other names
Advanced Dermatology and Cosmetic Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Authorized official
AMY DECLUE (DIRECTOR OF PROVIDER SERVICES)
(407) 875-2080
Entity
Organization
Contact information
Practice address
3006 17TH ST, SAINT CLOUD, FL 34769-6011
(407) 498-7100
(407) 498-7200
Mailing address
151 SOUTHHALL LN STE 300, MAITLAND, FL 32751-7172
(407) 875-2080
(407) 650-3455
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
Other
Enumeration date
11/26/2008
Last updated
07/21/2022
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