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NPI Code Detail

MEDICARE: HOLLACE D LEPPERT DO

MEDICARE:   HOLLACE D LEPPERT  DO
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
1207R00000XInternal Medicine PhysicianOS8674FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1110241874OTHERFLRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
33059936OTHERFLCIGNA
451988OTHERFLBCBS
54636764OTHERFLAETNA
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912905902
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLACE D LEPPERT DO
Provider Business Mailing Address
First Line : 2675 WINKLER AVE
Second Line : FL 2
City : FORT MYERS
State : FL
Zip : 33901-9342
Country : US
Telephone Number : 239-931-3440
Fax Number :
Provider Business Practice Location Address
First Line : 3571 DEL PRADO BLVD N
Second Line : SUITE 2
City : CAPE CORAL
State : FL
Zip : 33909-5286
Country : US
Telephone Number : 239-656-6300
Fax Number : 239-656-6765
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 08/05/2020

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Directions to “ HOLLACE D LEPPERT DO” Practice Location

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