Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | ME 78447 | FL |
NPI | 1023005212 |
---|---|
Provider Name | Dr. Leon Albert Bynoe |
First Address | Ft. Lauderdale, FL 33339 |
Second Address | Coral Springs, FL 33071 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2005 |
Last Update Date | 26/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
257192700 | (05) | FL |
BB5445463 | DEA (01) | |
G06091 | (02) |