Provider Demographics
NPI:1679975445
Name:LEUNG, KITTY (MD)
Entity Type:Individual
Prefix:
First Name:KITTY
Middle Name:
Last Name:LEUNG
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 1:580 WEST 8TH STREET
Mailing Address - Street 2:TOWER II, 6TH FL, SUITE 6005
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-1817
Mailing Address - Country:US
Mailing Address - Phone:904-244-3990
Mailing Address - Fax:904-244-4486
Practice Address - Street 1:580 WEST 8TH STREET
Practice Address - Street 2:TOWER II, 6TH FL, SUITE 6005
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-3100
Practice Address - Country:US
Practice Address - Phone:904-244-3990
Practice Address - Fax:904-244-4486
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1419542084P0800X
FLTRN20941390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program