Provider Demographics
NPI:1225231673
Name:LEEDS, BYRON WILLIAM (OD)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:WILLIAM
Last Name:LEEDS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2854 PALMETTO RIDGE PT
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-7370
Mailing Address - Country:US
Mailing Address - Phone:407-977-2821
Mailing Address - Fax:
Practice Address - Street 1:11250 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-4537
Practice Address - Country:US
Practice Address - Phone:407-249-8666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3303152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management