Organization
LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Active
Parent organization
LEAVITT MEDICAL ASSOCIATES OF FLORIDA INCE
Other names
ADVANCED DERMATOLOGY AND COSMETIC SURGERY
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEAVITT MEDICAL ASSOCIATES OF FLORIDA INCE
Authorized official
NEFRITA LOGAN PROVIDER SERVICE (REP)
(407) 875-2080
Entity
Organization
Contact information
Practice address
1513 S HARBOR CITY BLVD, MELBOURNE, FL 32901-4681
(321) 951-2639
(866) 948-8094
Mailing address
151 SOUTHHALL LN, SUITE 300, MAITLAND, FL 32751-7176
(407) 875-2080
(407) 875-0518
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
10/21/2010
Last updated
10/02/2013
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