Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME106310 | FL |
Y | 207XS0106X | Orthopaedic Hand Surgeon | ME106310 | FL |
NPI | 1174620702 |
---|---|
Provider Name | Brian Leung |
First Address | Orange City, FL 32763-8333 |
Second Address | Orange City, FL 32763-8333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2006 |
Last Update Date | 09/01/2021 |