Provider Demographics
NPI:1063445351
Name:PIANKO, LEONARD J (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:J
Last Name:PIANKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:21097 NE 27TH CT STE 110
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1206
Mailing Address - Country:US
Mailing Address - Phone:305-384-4720
Mailing Address - Fax:305-933-1749
Practice Address - Street 1:21097 NE 27TH CT STE 110
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1206
Practice Address - Country:US
Practice Address - Phone:305-384-4720
Practice Address - Fax:305-933-1749
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME50446207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063634700Medicaid
FLD50890Medicare UPIN
FL063634700Medicaid