MEDICARE: LEONID ALTSHULER 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	2084P0800X	Psychiatry Physician	ME104094	FL

General Provider Information

NPI Number	:	1518137959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEONID ALTSHULER M.D

Provider Business Mailing Address
First Line	:	PO BOX 811523
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33481-1523
Country	:	US
Telephone Number	:	347-782-7247
Fax Number	:

Provider Business Practice Location Address
First Line	:	2803 E COMMERCIAL BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4205
Country	:	US
Telephone Number	:	347-782-7247
Fax Number	:

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

Provider Enumeration Date	:	02/29/2008
Last Update Date	:	01/28/2013

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