Provider Demographics
NPI:1518203116
Name:SPERRY, LEONARD T (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:T
Last Name:SPERRY
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 1:3015 S. OCEAN BLVD SUITE 11A
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33487
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3015 S OCEAN BLVD APT 11A
Practice Address - Street 2:
Practice Address - City:HIGHLAND BEACH
Practice Address - State:FL
Practice Address - Zip Code:33487-1856
Practice Address - Country:US
Practice Address - Phone:561-297-3507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-31
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 81336208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice