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General NPI Number Information
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NPI Number | 1225231673
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Entity Type | Individual
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Provider Name | BYRON WILLIAM LEEDS O.D
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Gender | Male
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11250 E COLONIAL DR
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City | ORLANDO
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State | FL
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Zip | 32817-4537
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Country | US
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Telephone | 407-249-8666
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Fax |
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Provider Business Mailing Address
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Address Line | 2854 PALMETTO RIDGE PT
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City | OVIEDO
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State | FL
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Zip | 32765-7370
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Country | US
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Telephone | 407-977-2821
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 3303
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License Number State | FL
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