Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 11767 I | PR |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | ME132560 | FL |
NPI | 1164602231 |
---|---|
Provider Name | Dr. Karla M Leavitt |
First Address | Orlando, FL 32806-1014 |
Second Address | Orlando, FL 32806-1014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2007 |
Last Update Date | 19/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
105939000 | (05) | FL |