Provider Demographics
NPI:1003912023
Name:FEUER, ILEANA (DO)
Entity Type:Individual
Prefix:DR
First Name:ILEANA
Middle Name:
Last Name:FEUER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11553 S BREEZE PL
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8379
Mailing Address - Country:US
Mailing Address - Phone:561-358-0700
Mailing Address - Fax:
Practice Address - Street 1:11553 S BREEZE PL
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8379
Practice Address - Country:US
Practice Address - Phone:561-358-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0005329207L00000X
FLOS5329207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL064162600Medicaid
FL80345OtherMEDICARE PTAN
FL80345OtherBCBS ID