Provider Demographics
NPI:1376761031
Name:D.G. & LEEDS, INC
Entity Type:Organization
Organization Name:D.G. & LEEDS, INC
Other - Org Name:ORLANDO PAIN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JUNAID
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-770-1444
Mailing Address - Street 1:3403 TECHNOLOGICAL AVE
Mailing Address - Street 2:SUITE # 4
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-1476
Mailing Address - Country:US
Mailing Address - Phone:407-770-1444
Mailing Address - Fax:
Practice Address - Street 1:7655 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-6903
Practice Address - Country:US
Practice Address - Phone:407-852-9797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC4398261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty