Organization
ADVANCED DERMATOLOGY OF MARYLAND PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT LOUIS LEAVITT DO (DO / OWNER)
(407) 875-2080
Entity
Organization
Contact information
Practice address
2401 RESEARCH BLVD STE 260, ROCKVILLE, MD 20850-3261
(301) 990-6565
(301) 990-8525
Mailing address
151 SOUTHHALL LN, SUITE 300, MAITLAND, FL 32751-7176
(407) 875-2080
(407) 650-3455
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8025029
—
MD
Enumeration date
11/18/2015
Last updated
01/22/2018
Update your record
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