Organization
LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Active
Parent organization
LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Other names
Advanced Dermatology and Cosmetic Sur
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Authorized official
NEFRITA LOGAN (PROV SER REP)
(407) 875-2080
Entity
Organization
Contact information
Practice address
1300 NW 17TH AVE, SUITE 130, DELRAY BEACH, FL 33445-2578
(561) 819-0957
(561) 549-0173
Mailing address
2600 LAKE LUCIEN DR, SUITE 180, MAITLAND, FL 32751-7233
(407) 875-2080
(407) 875-0518
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256877213
—
FL
Enumeration date
05/30/2008
Last updated
04/21/2010
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