Provider Demographics
NPI:1780685172
Name:LEPORE, MICHAEL R (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:R
Last Name:LEPORE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:600 N CATTLEMEN RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6410
Mailing Address - Country:US
Mailing Address - Phone:941-371-6565
Mailing Address - Fax:941-377-7731
Practice Address - Street 1:600 N CATTLEMEN RD
Practice Address - Street 2:SUITE 220
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232
Practice Address - Country:US
Practice Address - Phone:941-371-6565
Practice Address - Fax:941-377-7731
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2018-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME810132086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262617900Medicaid
FL01783OtherBCBS
FLP00061645OtherMEDICARE RR
FL650501582OtherTAX ID
FLP00061645OtherMEDICARE RR
FLG19523Medicare UPIN