Leavitt Dermatopathology, LLC

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

Legal business name

LEAVITT DERMATOPATHOLOGY, LLC

Practice address

1300 NW 17TH Ave Ste 130
Delray Beach, FL 33445-2588

Phone

(561) 819-0857

Fax

(561) 549-0173

NPI assigned

Jul 16, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amy Declue

Title

Director, Provider Services

Phone

(407) 875-2080

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425340800000",
    "number": "1124331350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN",
            "address_2": "SUITE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517176",
            "telephone_number": "407-875-2080",
            "fax_number": "407-875-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 NW 17TH AVE STE 130",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334452588",
            "telephone_number": "561-819-0857",
            "fax_number": "561-549-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAVITT DERMATOPATHOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2015-03-03",
        "status": "A",
        "authorized_official_last_name": "DECLUE",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "DIRECTOR, PROVIDER SERVICES",
        "authorized_official_telephone_number": "407-875-2080"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivier Le Gloahec, DNP, FNP
• Ryan Tong Le, DPT
• Mallory Leach
• Lead Connect Consulting LLC
• Stuart Jay Leaderman, DO
• Leavitt Medical Associates of Florida Inc
• Leavitt Medical Associates of Florida Inc
• Fenton Gregory Lebon I, MD
• Diana Renee Lebrun, LCSW
• Adriana Lechuga Cabrera

• Dermatopathology Physician in Delray Beach, FL
• Providers in Delray Beach, FL by specialty
• Dermatopathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.