MEDICARE: DR. HEDI LOUISE LEISTNER MD

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	2080P0214X	Pediatric Pulmonology Physician	120739-1	NY
2	2080P0214X	Pediatric Pulmonology Physician	MD2015-0199	NM
3	2080P0214X	Pediatric Pulmonology Physician	046012	CT
4	2080P0214X	Pediatric Pulmonology Physician	ME138418	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831148394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEDI LOUISE LEISTNER MD

Provider Business Mailing Address
First Line	:	108 TIMBERVIEW DR
Second Line	:
City	:	SAFETY HARBOR
State	:	FL
Zip	:	34695-4734
Country	:	US
Telephone Number	:	727-771-7606
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 TIMBERVIEW DR
Second Line	:
City	:	SAFETY HARBOR
State	:	FL
Zip	:	34695-4734
Country	:	US
Telephone Number	:	727-776-7606
Fax Number	:

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	07/23/2022

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Directions to “ DR. HEDI LOUISE LEISTNER MD” Practice Location

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