Healthcare Provider Details

I. General information

NPI: 1053356048
Provider Name (Legal Business Name): LEAH RAGUINDIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

301 BEECH ST APT #12H
HACKENSACK NJ
07601-2114
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0301
  • Fax:
Mailing address:
  • Phone: 201-678-1523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberME138502
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberME138502
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number35.133876
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberMA058373
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: