Healthcare Provider Details

I. General information

NPI: 1174538896
Provider Name (Legal Business Name): LEONARD CALODNEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 04/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 N SUNCOAST BLVD C/O SEVEN RIVERS REGIONAL
CRYSTAL RIVER FL
34428-6712
US

IV. Provider business mailing address

PO BOX 742318
ATLANTA GA
30374-2103
US

V. Phone/Fax

Practice location:
  • Phone: 352-795-4008
  • Fax: 352-795-9041
Mailing address:
  • Phone: 317-614-9863
  • Fax: 844-876-0873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME016821
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: