MEDICARE: DEBBIE LEITER RPT PA

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	225100000X	Physical Therapist	PT4810FL	FL

General Provider Information

NPI Number	:	1033206776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEBBIE LEITER RPT PA

Provider Business Mailing Address
First Line	:	8613 SW 80 COURT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-7036
Country	:	US
Telephone Number	:	305-662-2800
Fax Number	:	305-668-3117

Provider Business Practice Location Address
First Line	:	6075 SW 72 STREET
Second Line	:	SUITE 203
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5000
Country	:	US
Telephone Number	:	305-662-2800
Fax Number	:	305-668-3117

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	MS. DEBORAR LYN LEITER
Credential	:	PT
Telephone Number	:	305-662-2800

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	08/22/2020

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