Provider Demographics
NPI:1528039617
Name:NASCA, LEONARDO SALVATORE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARDO
Middle Name:SALVATORE
Last Name:NASCA
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 44008
Mailing Address - Street 2:UFJP PROVIDER ENROLLMENT
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4008
Mailing Address - Country:US
Mailing Address - Phone:904-244-3660
Mailing Address - Fax:904-244-3425
Practice Address - Street 1:655 W 8TH ST
Practice Address - Street 2:UFJP EMERGENCY MEDICINE
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6511
Practice Address - Country:US
Practice Address - Phone:904-244-1122
Practice Address - Fax:904-244-5666
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2007-08-30
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Provider Licenses
StateLicense IDTaxonomies
FLME45313207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0424927-00Medicaid
GA000797365BMedicaid
FL930063247OtherRAILROAD MEDICARE
FL0424927-00Medicaid
FL15957TMedicare PIN