Provider Demographics
NPI:1811078454
Name:GRALNIK, LEONARD MARK (MD)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:MARK
Last Name:GRALNIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1600 S ANDREWS AVE
Mailing Address - Street 2:SUITE 1090, WEST WING
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2510
Mailing Address - Country:US
Mailing Address - Phone:954-523-2727
Mailing Address - Fax:354-523-8814
Practice Address - Street 1:11200 SW 8TH ST
Practice Address - Street 2:AHC 2, 693
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33199-2516
Practice Address - Country:US
Practice Address - Phone:305-348-4260
Practice Address - Fax:305-348-4430
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME566142084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373088300Medicaid
FL373088300Medicaid
FL23039ZMedicare ID - Type Unspecified