MEDICARE: RICARDO R LEONI II M.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	207W00000X	Ophthalmology Physician	022671	LA

General Provider Information

NPI Number	:	1235159708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICARDO R LEONI II M.D.

Provider Business Mailing Address
First Line	:	203 RUE LOUIS XIV
Second Line	:	SUITE A
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-5736
Country	:	US
Telephone Number	:	337-981-2393
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 RUE LOUIS XIV
Second Line	:	SUITE A
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-5736
Country	:	US
Telephone Number	:	337-981-2393
Fax Number	:

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	07/08/2007

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