MEDICARE: DR. LEELAN NICHOLAS MICHAEL BHAGWANDEEN PSYD

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	103G00000X	Clinical Neuropsychologist	PY13112	FL

General Provider Information

NPI Number	:	1093661159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEELAN NICHOLAS MICHAEL BHAGWANDEEN PSYD

Provider Business Mailing Address
First Line	:	2938 JANET PL
Second Line	:
City	:	HAMMOND
State	:	IN
Zip	:	46323-1137
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 SE HILLMOOR DR STE 201
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-8057
Country	:	US
Telephone Number	:	772-278-5508
Fax Number	:

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

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

Similar Medicare Providers

1003882150 — DR. KAJAL DASGUPTA M.D.
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-2424
Practice Fax:

1881646115 — MS. MELISSA RYAN STRAUSS P.A.
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-2424
Practice Fax:

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1215947155 — MR. JOHN MICHAEL POLI LMHC, CAP
Practice Location Address:

2100 SE HILLMOOR DR STE 201
PORT ST LUCIE, FL
34952-8057

Practice Phone: 722-285-5445
Practice Fax:

1730235276 — MIHOM HEALTHCARE INC.
Practice Location Address:

2100 SE HILLMOOR DR STE 102
PORT ST LUCIE, FL
34952-8057

Practice Phone: 772-873-3838
Practice Fax: 772-873-3839

Directions to “ DR. LEELAN NICHOLAS MICHAEL BHAGWANDEEN PSYD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.