Provider Demographics
NPI:1447244033
Name:PAN, LEONA YUQUN (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONA
Middle Name:YUQUN
Last Name:PAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8760 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-4118
Mailing Address - Country:US
Mailing Address - Phone:914-319-3135
Mailing Address - Fax:
Practice Address - Street 1:8760 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33076-4118
Practice Address - Country:US
Practice Address - Phone:914-319-3135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22453-1207L00000X
FLME147124207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01566494Medicaid
NY02387497Medicaid
NY02387497Medicaid
NY01566494Medicaid
NYH74325Medicare UPIN