Provider Demographics
NPI:1588659353
Name:BERKOWITZ, LEONARD KYLE (DO)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:KYLE
Last Name:BERKOWITZ
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 1:880 NW 13TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2342
Mailing Address - Country:US
Mailing Address - Phone:561-566-5328
Mailing Address - Fax:561-299-4220
Practice Address - Street 1:880 NW 13TH ST STE 400
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2342
Practice Address - Country:US
Practice Address - Phone:561-566-5328
Practice Address - Fax:561-299-4220
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13867207Q00000X
NY188174207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ60088900OtherHORIZON NJ HEALTH
NJ1962712471OtherMEDICARE
NJ271055Medicaid
NJ3854939000OtherAMERIHEALTH
NJ1588659353OtherAETNA
NJ273616102OtherUNITED HEALTHCARE
NJY01445472OtherAMERIGROUP
NJ273616102OtherAMERICHOICE
NJP4343130OtherOXFORD