LEDER RETINA NPI 1609398916

NPI Information

NPI: 1609398916
Provider Name: LEDER RETINA

Doing Business As: LEDER RETINA & UVEITIS SPECIALIST

Classification: Ophthalmology - 207WX0107X
Entity Type: Organization

Specialization: Retina Specialist

Address:
13241 BARTRAM PARK BLVD UNIT 809
JACKSONVILLE, FL
ZIP 32258
Phone: (904) 201-9887
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LEDER RETINA is a retina specialist ophthalmology in Jacksonville, FL. The provider is an ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. LEDER RETINA NPI is 1609398916. The provider is registered as an organization entity type.
The provider Is Doing Business As Leder Retina & Uveitis Specialist.

The provider's business location address is:

13241 BARTRAM PARK BLVD UNIT 809
JACKSONVILLE, FL
ZIP 32258-216
Phone: (904) 201-9887
Fax: (904) 325-6434

The provider's authorized official is Henry Alexander Leder .
The authorized official title is Owner and has the following contact phone number (904) 201-9887.

The enumeration date for this NPI number is 7/10/2017 and was last updated on 4/2/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QS0132X	Clinic/Center	Ophthalmologic Surgery	D64669	MARYLAND	No
2	207WX0108X	Ophthalmology	Uveitis and Ocular Inflammatory Disease			No
3	261Q00000X	Clinic/Center		D64669	MARYLAND	No
4	207WX0107X	Ophthalmology	Retina Specialist			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	048036300	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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