Provider Demographics
NPI:1043742034
Name:LEONARD J. SKZYNSKI, PSY.D.
Entity Type:Organization
Organization Name:LEONARD J. SKZYNSKI, PSY.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SKIZYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:321-284-1840
Mailing Address - Street 1:21 S RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-5443
Mailing Address - Country:US
Mailing Address - Phone:321-284-1840
Mailing Address - Fax:321-284-1854
Practice Address - Street 1:21 S RANDOLPH AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5443
Practice Address - Country:US
Practice Address - Phone:321-284-1840
Practice Address - Fax:321-284-1854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3764302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1275684870OtherNPI