Provider Demographics
NPI:1225270663
Name:REITBLAT, LITAL (MD)
Entity Type:Individual
Prefix:DR
First Name:LITAL
Middle Name:
Last Name:REITBLAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LITAL
Other - Middle Name:
Other - Last Name:DARDIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5685
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:1131 N 35TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021
Practice Address - Country:US
Practice Address - Phone:954-265-6984
Practice Address - Fax:954-265-9343
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1222552080P0205X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1513UOtherFL BLUE
FL015269200Medicaid
FLIG247ZMedicare PIN