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NPI Code Detail

MEDICARE: DR. LESLIE A HUSZAR M.D.

MEDICARE:  DR. LESLIE A HUSZAR  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
12084N0600XClinical Neurophysiology PhysicianME0057023FL
22084N0400XNeurology PhysicianME0057023FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1110011008OTHERFLRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2399371OTHERNYEMPIRE BCBS OF NY
3993193OTHERPABLUE SHIELD OF PA
427901OTHERFLBC BS OF FLORIDA

General Provider Information

NPI Number : 1528063492
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LESLIE A HUSZAR M.D.
Provider Business Mailing Address
First Line : 7390 45TH ST
Second Line :
City : VERO BEACH
State : FL
Zip : 32967-7708
Country : US
Telephone Number : 772-299-8422
Fax Number : 772-365-0861
Provider Business Practice Location Address
First Line : 3725 10TH CT
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-6559
Country : US
Telephone Number : 772-299-8422
Fax Number : 772-365-0861
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 04/12/2021

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