Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | G81070 | CA |
N | 208600000X | Surgeon | G81070 | CA |
Y | 2082S0105X | Plastic Hand Surgeon | ME128087 | FL |
NPI | 1366519266 |
---|---|
Provider Name | Kenneth Leong |
First Address | Bradenton, FL 34209-6131 |
Second Address | Sarasota, FL 34239 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 20/08/2018 |