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General NPI Number Information
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NPI Number | 1992016547
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Entity Type | Organization
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Legal Business Name | DOUGLAS R LEDER DO PA
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Dates
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Enumeration Date | 06/29/2010
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 500 NORTHPOINT PKWY #100
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-1903
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Country | US
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Telephone | 561-686-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 500 NORTHPOINT PKWY #100
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-1903
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Country | US
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Telephone | 561-686-2020
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DOUGLAS R LEDER
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Credential | D.O.
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Telephone | 561-686-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | OS4720
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License Number State | FL
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