Provider Demographics
NPI:1699769281
Name:LE, HOA V (MD)
Entity type:Individual
Prefix:DR
First Name:HOA
Middle Name:V
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 49TH ST N
Mailing Address - Street 2:SUITE S-204
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2146
Mailing Address - Country:US
Mailing Address - Phone:727-525-0239
Mailing Address - Fax:727-525-0807
Practice Address - Street 1:5800 49TH ST N
Practice Address - Street 2:SUITE S-204
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2146
Practice Address - Country:US
Practice Address - Phone:727-525-0239
Practice Address - Fax:727-525-0807
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90612207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270989900Medicaid
FL03482OtherBC FL
FLP00144910OtherRAILROAD MEDICARE
FLU3042ZMedicare ID - Type Unspecified
FLU3042YMedicare UPIN
FLU3042ZMedicare Oscar/Certification
FLI13262Medicare UPIN