MEDICARE: BETH M LEITNER PSY.D.

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	103T00000X	Psychologist	PY7692	FL

General Provider Information

NPI Number	:	1427371046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH M LEITNER PSY.D.

Provider Business Mailing Address
First Line	:	1347 NW 108TH AVE
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-8216
Country	:	US
Telephone Number	:	954-632-4597
Fax Number	:

Provider Business Practice Location Address
First Line	:	1347 NW 108TH AVE
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-8216
Country	:	US
Telephone Number	:	954-632-4597
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2010
Last Update Date	:	02/03/2026

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