Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | ME92891 | FL |
Y | 2086S0122X | Plastic and Reconstructive Surgery | ME92891 | FL |
NPI | 1578558557 |
---|---|
Provider Name | Dr. Leonik Angelo Ahumada |
First Address | Ocala, FL 34474-3371 |
Second Address | Ocala, FL 34474-3371 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2005 |
Last Update Date | 20/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
16194 | BCBS (01) | FL |
I32738 | (02) | FL |