MEDICARE: DR. LEON HENDLEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	ME0044169	FL

General Provider Information

NPI Number	:	1043213291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEON HENDLEY M.D.

Provider Business Mailing Address
First Line	:	1300 36TH STREET
Second Line	:	SUITE C
City	:	VERO BEACH
State	:	FL
Zip	:	32960
Country	:	US
Telephone Number	:	772-770-4911
Fax Number	:	772-569-4583

Provider Business Practice Location Address
First Line	:	1300 36TH STREET
Second Line	:	SUITE C
City	:	VERO BEACH
State	:	FL
Zip	:	32960
Country	:	US
Telephone Number	:	772-770-4911
Fax Number	:	772-569-4583

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	11/25/2014

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