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NPI Code Detail

MEDICARE: LEESBURG REGIONAL MEDICAL CENTER INC

MEDICARE: LEESBURG REGIONAL MEDICAL CENTER INC
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
1282N00000XGeneral Acute Care Hospital
2282N00000XGeneral Acute Care HospitalFL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1328OTHERFLBLUE CROSS ID
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245226190
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEESBURG REGIONAL MEDICAL CENTER INC
Provider Business Mailing Address
First Line : 600 E. DIXIE AVENUE
Second Line : ATTN: REIMBURSEMENT DEPT.
City : LEESBURG
State : FL
Zip : 34748-5994
Country : US
Telephone Number : 352-323-5762
Fax Number : 352-323-5039
Provider Business Practice Location Address
First Line : 600 E DIXIE AVE
Second Line :
City : LEESBURG
State : FL
Zip : 34748-5925
Country : US
Telephone Number : 352-323-5762
Fax Number : 352-323-5239
Authorized Official
Title or Position : PRESIDENT/CHIEF EXECUTIVE OFFICER
Name : MR. JAMES J KELLY JR.
Credential :
Telephone Number : 352-733-1600
Provider Enumeration Date : 09/26/2005
Last Update Date : 12/07/2022

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Directions to “LEESBURG REGIONAL MEDICAL CENTER INC ” Practice Location

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