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Individual

DR. RONALD LEAVITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12670 CREEKSIDE LN, SUITE 202, FORT MYERS, FL 33919-3370
(239) 482-2663
Mailing address
12670 CREEKSIDE LN, SUITE 202, FORT MYERS, FL 33919-3370
(239) 482-2663

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
21597
CT
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
042-0011868
VT
207XS0106X
Orthopaedic Hand Surgery Physician
21597
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001215979
CT
Enumeration date
11/07/2005
Last updated
02/25/2013
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