Provider Demographics
NPI:1508175530
Name:CHOE, LEO (DO)
Entity Type:Individual
Prefix:DR
First Name:LEO
Middle Name:
Last Name:CHOE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13644 WALSINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3532
Mailing Address - Country:US
Mailing Address - Phone:727-595-2519
Mailing Address - Fax:727-595-3872
Practice Address - Street 1:13644 WALSINGHAM RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-3532
Practice Address - Country:US
Practice Address - Phone:727-595-2519
Practice Address - Fax:727-595-3872
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO2460207R00000X
FLOS12102207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008643000Medicaid
FLHG822ZMedicare PIN