MEDICARE: ROSALIA LEITE-EVANS MD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	96150	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518270149
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSALIA LEITE-EVANS MD LLC

Provider Business Mailing Address
First Line	:	745 US 1
Second Line	:	SUITE 203
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-4409
Country	:	US
Telephone Number	:	561-247-0825
Fax Number	:	561-491-2503

Provider Business Practice Location Address
First Line	:	745 US 1
Second Line	:	SUITE 203
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-4409
Country	:	US
Telephone Number	:	561-247-0825
Fax Number	:	561-491-2503

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. ROSALIA PADREDI LEITE-EVANS
Credential	:	MD
Telephone Number	:	561-247-0825

Provider Enumeration Date	:	07/25/2010
Last Update Date	:	07/26/2010

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