MEDICARE: LEONIDO LUZNIK 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	207RX0202X	Medical Oncology Physician	D52747	MD
2	207RH0003X	Hematology & Oncology Physician	U9304	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518902261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEONIDO LUZNIK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 64474
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21264-4474
Country	:	US
Telephone Number	:	410-614-6398
Fax Number	:

Provider Business Practice Location Address
First Line	:	1919 OLD SPANISH TRL
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2003
Country	:	US
Telephone Number	:	713-798-4321
Fax Number	:

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

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	07/03/2024

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