Provider Demographics
NPI:1326158270
Name:REMENSON, LEONID ALEXANDROVICH (MD)
Entity Type:Individual
Prefix:
First Name:LEONID
Middle Name:ALEXANDROVICH
Last Name:REMENSON
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 1:5350 ATLANTIC AVE
Mailing Address - Street 2:STE 106
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8112
Mailing Address - Country:US
Mailing Address - Phone:561-638-9219
Mailing Address - Fax:888-714-0574
Practice Address - Street 1:5350 ATLANTIC AVE
Practice Address - Street 2:STE 106
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8112
Practice Address - Country:US
Practice Address - Phone:561-638-9219
Practice Address - Fax:888-714-0574
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL832732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG83882Medicare UPIN
FLE6529YMedicare ID - Type Unspecified