MEDICARE: LEONARD T SPERRY 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	208D00000X	General Practice Physician	ME 81336	FL

General Provider Information

NPI Number	:	1518203116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEONARD T SPERRY M.D.

Provider Business Mailing Address
First Line	:	3015 S. OCEAN BLVD SUITE 11A
Second Line	:
City	:	HIGHLAND BEACH
State	:	FL
Zip	:	33487
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3015 S OCEAN BLVD APT 11A
Second Line	:
City	:	HIGHLAND BEACH
State	:	FL
Zip	:	33487-1856
Country	:	US
Telephone Number	:	561-297-3507
Fax Number	:

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

Provider Enumeration Date	:	12/31/2012
Last Update Date	:	12/31/2012

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