Provider Demographics
NPI:1780660837
Name:SUKIENIK, LEONARD (DO)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:
Last Name:SUKIENIK
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 1:13005 SOUTHERN BLVD
Mailing Address - Street 2:SUITE 221
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-9206
Mailing Address - Country:US
Mailing Address - Phone:561-784-0473
Mailing Address - Fax:561-784-9038
Practice Address - Street 1:13005 SOUTHERN BLVD
Practice Address - Street 2:SUITE 221
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9206
Practice Address - Country:US
Practice Address - Phone:561-784-0473
Practice Address - Fax:561-784-9038
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207R00000X207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL57202XMedicare PIN
FLG16326Medicare UPIN