MEDICARE: LEONARD J DEUTSCH MD PA

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	2084P0800X	Psychiatry Physician	ME0011640	FL

General Provider Information

NPI Number	:	1235428558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEONARD J DEUTSCH MD PA

Provider Business Mailing Address
First Line	:	9801 COLLINS AVE APT 14Z
Second Line	:
City	:	BAL HARBOUR
State	:	FL
Zip	:	33154-1830
Country	:	US
Telephone Number	:	305-865-1141
Fax Number	:	305-861-7167

Provider Business Practice Location Address
First Line	:	9801 COLLINS AVE APT 14Z
Second Line	:
City	:	BAL HARBOUR
State	:	FL
Zip	:	33154-1830
Country	:	US
Telephone Number	:	305-865-1141
Fax Number	:	305-861-7167

Authorized Official
Title or Position	:	BOOKKEEPER
Name	:	MRS. ELLEN UNGAR
Credential	:
Telephone Number	:	212-860-3393

Provider Enumeration Date	:	04/07/2011
Last Update Date	:	04/07/2011

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