MEDICARE: LEONARD ERDMAN 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	207R00000X	Internal Medicine Physician	ME0006780	FL

General Provider Information

NPI Number	:	1891801767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEONARD ERDMAN MD

Provider Business Mailing Address
First Line	:	1130 BAYVIEW DR
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33304-2505
Country	:	US
Telephone Number	:	954-563-3158
Fax Number	:	954-563-5874

Provider Business Practice Location Address
First Line	:	1130 BAYVIEW DR
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33304-2505
Country	:	US
Telephone Number	:	954-563-3158
Fax Number	:	954-563-5874

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

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	03/15/2008

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