Individual
MATT LOUIS LEAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
260 LOOKOUT PL, STE 103, MAITLAND, FL 32751-4485
(407) 373-0700
(407) 333-2140
Mailing address
151 SOUTHHALL LN, STE 300, MAITLAND, FL 32751-7176
(407) 875-2080
(407) 650-3455
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
OS5365
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063702500
—
FL
Enumeration date
08/30/2006
Last updated
01/21/2016
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