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NPI Code Detail

MEDICARE: DR. MARK G LEITNER DPM

MEDICARE:  DR. MARK G LEITNER  DPM
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
1213E00000XPodiatristPO2569FL
2213ES0103XFoot & Ankle Surgery PodiatristPO2569FL
3213ES0131XFoot Surgery PodiatristPO2569FL
4213EP1101XPrimary Podiatric Medicine PodiatristPO2569FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00415451OTHERFLRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2202703OTHERFLAMERIGROUP
310172301OTHERFLCITRUS
4864973OTHERFLUHC
576166OTHERFLBEECHSTREET
6PO2569OTHERLICENSE NO
71006007OTHERFLHEALTHNET/CAREPLUS
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
94961325OTHERFLCIGNA
1065462OTHERFLBCBS

General Provider Information

NPI Number : 1962401067
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK G LEITNER DPM
Provider Business Mailing Address
First Line : 206 BUCKINGHAM PL
Second Line : SUITE 101
City : BRANDON
State : FL
Zip : 33511-4910
Country : US
Telephone Number : 813-571-2977
Fax Number : 813-654-9545
Provider Business Practice Location Address
First Line : 206 BUCKINGHAM PL
Second Line : SUITE 101
City : BRANDON
State : FL
Zip : 33511-4910
Country : US
Telephone Number : 813-571-2977
Fax Number : 813-654-9545
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 09/30/2011

Similar Medicare Providers

1376621888 — MARK G LEITNER DPM PA
Practice Location Address:
206 BUCKINGHAM PL , SUITE 101
BRANDON, FL
33511-4910
Practice Phone: 813-571-2977
Practice Fax: 813-654-9545
1639257207 — BRANDI M JOHNSON DPM
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1407276991 — JAMES MASON
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Practice Fax:
1730566076 — SARAH TEDDER
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1366393712 — INTEGRAONE LLC
Practice Location Address:
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Directions to “ DR. MARK G LEITNER DPM” Practice Location

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