Provider Demographics
NPI:1689642993
Name:LEANO, RICARDO A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:A
Last Name:LEANO
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 1:5610 PGA BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-3838
Mailing Address - Country:US
Mailing Address - Phone:561-248-1166
Mailing Address - Fax:561-781-8020
Practice Address - Street 1:5610 PGA BLVD STE 210
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-3838
Practice Address - Country:US
Practice Address - Phone:561-248-1166
Practice Address - Fax:561-781-8020
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01078103A207L00000X
NY227484-1207L00000X
FLME 87536208VP0014X, 208VP0014X
FLME87536207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015251200Medicaid
FL78755NMedicare PIN
NY03409634Medicaid