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
725 W GRANADA BLVD STE 44, ORMOND BEACH, FL 32174-9406
(386) 898-0547
(386) 898-0551
Mailing address
2600 LAKE LUCIEN DR STE 180, MAITLAND, FL 32751-7235
(407) 875-2080
(407) 875-0518
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
208200000X
Plastic Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256877221
—
FL
Enumeration date
05/30/2008
Last updated
04/21/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us