Provider Demographics
NPI:1154793909
Name:MARKOV, LEONID (PHARMD)
Entity type:Individual
Prefix:
First Name:LEONID
Middle Name:
Last Name:MARKOV
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11001 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2954
Mailing Address - Country:US
Mailing Address - Phone:702-948-8355
Mailing Address - Fax:
Practice Address - Street 1:3540 NW 56TH ST STE 204
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-2260
Practice Address - Country:US
Practice Address - Phone:877-367-3479
Practice Address - Fax:833-347-9329
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18612183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist