Provider Demographics
NPI:1043240575
Name:BAUMANN, LESLIE S (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:S
Last Name:BAUMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4500 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137
Mailing Address - Country:US
Mailing Address - Phone:305-532-5552
Mailing Address - Fax:305-534-5224
Practice Address - Street 1:4500 BISCAYNE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137
Practice Address - Country:US
Practice Address - Phone:305-532-5552
Practice Address - Fax:305-534-5224
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME72961207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2528801-00Medicaid
FL42317Medicare ID - Type Unspecified
FLG63306Medicare UPIN