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NPI Code Detail

MEDICARE: DR. LEONIK ANGELO AHUMADA M.D.

MEDICARE: DR. LEONIK ANGELO AHUMADA 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
12086S0122XPlastic and Reconstructive Surgery PhysicianME92891FL
22082S0099XPlastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianME92891FL
32082S0105XSurgery of the Hand (Plastic Surgery) PhysicianME92891FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
116194OTHERFLBCBS

General Provider Information

NPI Number : 1578558557
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEONIK ANGELO AHUMADA M.D.
Provider Business Mailing Address
First Line : 3320 SW 34TH CIR
Second Line :
City : OCALA
State : FL
Zip : 34474-3371
Country : US
Telephone Number : 352-629-8154
Fax Number : 352-629-5231
Provider Business Practice Location Address
First Line : 3320 SW 34TH CIR
Second Line :
City : OCALA
State : FL
Zip : 34474-3371
Country : US
Telephone Number : 352-629-8154
Fax Number : 352-629-5231
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2005
Last Update Date : 08/20/2010

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