Healthcare Provider Details

I. General information

NPI: 1972065167
Provider Name (Legal Business Name): LEERAN BARANESS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2019
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 N FEDERAL HWY
FORT LAUDERDALE FL
33308-1427
US

IV. Provider business mailing address

6401 N FEDERAL HWY
FORT LAUDERDALE FL
33308-1427
US

V. Phone/Fax

Practice location:
  • Phone: 954-776-8500
  • Fax:
Mailing address:
  • Phone: 954-776-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME154710
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: