Provider Demographics
NPI:1093731739
Name:HOENIG, LEONARD JACOB (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:JACOB
Last Name:HOENIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N FLAMINGO RD
Mailing Address - Street 2:SUITE #201
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1015
Mailing Address - Country:US
Mailing Address - Phone:954-438-0077
Mailing Address - Fax:954-438-4620
Practice Address - Street 1:601 N FLAMINGO RD
Practice Address - Street 2:SUITE #201
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1015
Practice Address - Country:US
Practice Address - Phone:954-438-0077
Practice Address - Fax:954-438-4620
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39186207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD62189Medicare UPIN
FL30575Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER