Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 34779 | SC |
Y | 207W00000X | Ophthalmologist | ME129068 | FL |
N | 208200000X | Surgeon | LL 34779 | SC |
N | 208600000X | Surgeon | LL 34779 | SC |
NPI | 1013279496 |
---|---|
Provider Name | Dr. Leah Lynn Kammerdiener |
First Address | Jacksonville, FL 32223-1627 |
Second Address | Jacksonville, FL 32256-5835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2012 |
Last Update Date | 11/10/2019 |