Provider Demographics
NPI:1457885584
Name:LEISER, SCOTT DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:DAVID
Last Name:LEISER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7593 W BOYNTON BEACH BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-6162
Mailing Address - Country:US
Mailing Address - Phone:561-649-7000
Mailing Address - Fax:
Practice Address - Street 1:1880 N CONGRESS AVE STE 303A
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8675
Practice Address - Country:US
Practice Address - Phone:561-734-8111
Practice Address - Fax:561-734-2993
Is Sole Proprietor?:No
Enumeration Date:2017-04-15
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME169942207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program