Provider Demographics
NPI:1982624086
Name:FELD, LEONARD G (MD)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:G
Last Name:FELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3100 SW 62ND AVE
Mailing Address - Street 2:3RD FLOOR ADMINISTRATION
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3009
Mailing Address - Country:US
Mailing Address - Phone:305-668-5523
Mailing Address - Fax:305-665-1576
Practice Address - Street 1:3100 SW 62ND AVE
Practice Address - Street 2:3RD FLOOR ADMINISTRATION
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3009
Practice Address - Country:US
Practice Address - Phone:305-668-5523
Practice Address - Fax:305-665-1576
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200600108208000000X
NC2006-001082080P0210X
FLME794432080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1411XOtherNCBCBS
NC5903356Medicaid
SCN08006Medicaid
NC2051639AMedicare PIN
NC5903356Medicaid
NC1411XOtherNCBCBS