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
NEFRITA LOGAN (PROVIDER SERVICE REP)
(407) 875-2080
Entity
Organization
Contact information
Practice address
3427 MARINER BLVD, SPRING HILL, FL 34609-2463
(888) 540-9660
(407) 875-0518
Mailing address
2600 LAKE LUCIEN DR, SUITE 180, MAITLAND, FL 32751-7233
(407) 875-2080
(407) 875-0518
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
Other
Enumeration date
04/14/2011
Last updated
04/14/2011
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