Leavitt Medical Associates Of Florida INC
Dermatology in Melbourne, FL. Organization (NPI-2).
NPI number1881925006
StatusActive
Last updated in NPPESDec 9, 2013
Details
- NPI
- 1881925006
- Entity type
- Organization (NPI-2)
- Legal business name
- Leavitt Medical Associates Of Florida INC
- Organization subpart
- Yes
- Enumeration date
- Jan 28, 2010
- Last updated
- Dec 9, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | – | FL | Yes |
Other names
- Advanced Dermatology And Cosmetic Suregery (Doing Business As)
Practice location
1515 W Nasa BlvdSte 100
Melbourne, FL 32901-2605
Phone 321-308-0659 · Fax 321-309-2881
Mailing address
151 Southhall LnSte 300
Maitland, FL 32751-7176
Phone 407-875-2080 · Fax 407-650-3455
Authorized official
Nefrita Logan
Provider Service Rep
4078752080
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