Provider Demographics
NPI:1366897621
Name:GODUNI, LEDIANA (MD)
Entity type:Individual
Prefix:
First Name:LEDIANA
Middle Name:
Last Name:GODUNI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24075 COMMERCE PARK
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5846
Mailing Address - Country:US
Mailing Address - Phone:216-831-5700
Mailing Address - Fax:216-839-4905
Practice Address - Street 1:24075 COMMERCE PARK
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5846
Practice Address - Country:US
Practice Address - Phone:216-831-5700
Practice Address - Fax:216-839-4905
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME144655207W00000X
390200000X
OH35145319207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program