Provider Demographics
NPI:1033206776
Name:DEBBIE LEITER RPT PA
Entity Type:Organization
Organization Name:DEBBIE LEITER RPT PA
Other - Org Name:LEITER PHYSICAL THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAR
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:LEITER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:305-662-2800
Mailing Address - Street 1:8613 SW 80 COURT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7036
Mailing Address - Country:US
Mailing Address - Phone:305-662-2800
Mailing Address - Fax:305-668-3117
Practice Address - Street 1:6075 SW 72 STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5000
Practice Address - Country:US
Practice Address - Phone:305-662-2800
Practice Address - Fax:305-668-3117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT4810FL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y8673Medicare ID - Type Unspecified