Organization
LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Active
Parent organization
LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Other names
Advanced Dermatology and Cosmetic Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Authorized official
AMY DECLUE (DIRECTOR, PROVIDER SERVICES)
(407) 875-2080
Entity
Organization
Contact information
Practice address
2902 59TH ST W, SUITE A, BRADENTON, FL 34209-7023
(941) 757-0763
(941) 757-0725
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
—
FL
Other
Enumeration date
01/18/2011
Last updated
12/04/2014
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