Healthcare Provider Details

I. General information

NPI: 1134414147
Provider Name (Legal Business Name): LEON LEWENSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2011
Last Update Date: 06/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 N OCEAN BLVD 707
BOCA RATON FL
33431-5364
US

IV. Provider business mailing address

4301 N OCEAN BLVD 707
BOCA RATON FL
33431
US

V. Phone/Fax

Practice location:
  • Phone: 561-368-2060
  • Fax:
Mailing address:
  • Phone: 561-368-2060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME 90991
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: