MEDICARE: LEISA YOUEL 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	174400000X	Specialist	ME51754	FL

General Provider Information

NPI Number	:	1093932006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEISA YOUEL M.D.

Provider Business Mailing Address
First Line	:	1005 LAKE FRONT LN
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32779-4827
Country	:	US
Telephone Number	:	407-788-9001
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 LAKE FRONT LN
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32779-4827
Country	:	US
Telephone Number	:	407-788-9001
Fax Number	:

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

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	07/08/2007

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Directions to “ LEISA YOUEL M.D.” Practice Location

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