Provider Demographics
NPI:1497718027
Name:MENA, LEANDRO ANTONIO (MD)
Entity type:Individual
Prefix:DR
First Name:LEANDRO
Middle Name:ANTONIO
Last Name:MENA
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 1:20 10TH ST NW UNIT 1504
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3869
Mailing Address - Country:US
Mailing Address - Phone:601-918-1194
Mailing Address - Fax:
Practice Address - Street 1:EMORY UNIVERSITY DIVISION INFECTIOUS DISEASES
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-4500
Practice Address - Country:US
Practice Address - Phone:404-712-2279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13129207P00000X
MS17860207RI0200X
GA102417207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1576107Medicaid
MSP01245275OtherRAILROAD PTAN
MS08920791Medicaid
MSP00755097Medicare PIN
MS302I448640Medicare PIN
LA1576107Medicaid
MS08920791Medicaid
MS440000026Medicare PIN