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General NPI Number Information
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NPI Number | 1063218782
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Entity Type | Organization
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Legal Business Name | LEELA MUNDRA MD, PLLC
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Dates
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Enumeration Date | 02/22/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 36 STEELE ST STE 200
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City | DENVER
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State | CO
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Zip | 80206-5710
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Country | US
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Telephone | 303-418-2277
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Fax | 303-418-2204
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Provider Business Mailing Address
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Address Line | 3814 GUNN HWY STE A
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City | TAMPA
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State | FL
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Zip | 33618-8789
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Country | US
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Telephone | 303-418-2277
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Fax | 303-418-2204
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Authorized Official
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Title or Position | PHYSICIAN
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Name | LEELA MUNDRA
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Credential | MD
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Telephone | 305-857-7707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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