MEDICARE: DR. SCOTT DAVID LEISER 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	ME169942	FL

General Provider Information

NPI Number	:	1457885584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT DAVID LEISER M.D.

Provider Business Mailing Address
First Line	:	7593 W BOYNTON BEACH BLVD STE 220
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-6162
Country	:	US
Telephone Number	:	561-649-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1880 N CONGRESS AVE STE 303A
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-8675
Country	:	US
Telephone Number	:	561-734-8111
Fax Number	:	561-734-2993

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

Provider Enumeration Date	:	04/15/2017
Last Update Date	:	03/17/2025

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