Organization
PALM BAY PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DORIS MARGARITA LEEDY M.D. (OWNER/PHYSICIAN)
(321) 722-8435
Entity
Organization
Contact information
Practice address
775 MALABAR RD, MALABAR, FL 32950-3120
(321) 722-8435
(321) 722-8486
Mailing address
775 MALABAR RD, MALABAR, FL 32950-3120
(321) 722-8435
(321) 722-8486
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME63747
FL
2080P0205X
Pediatric Endocrinology Physician
ME63747
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18683
BLUE CROSS BLUE SHIELD
FL
05
—
372797100
—
FL
01
—
3736201002
CIGNA
FL
01
—
632833
AETNA
FL
01
—
E41429
UPIN
FL
Enumeration date
09/09/2008
Last updated
09/09/2008
Update your record
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