Provider Demographics
NPI:1811915184
Name:HURWITZ, LESLIE ANN (DO)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ANN
Last Name:HURWITZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3080 NW 99TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4038
Mailing Address - Country:US
Mailing Address - Phone:954-753-0500
Mailing Address - Fax:954-753-0531
Practice Address - Street 1:2901 CORAL HILLS DR STE 150
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4146
Practice Address - Country:US
Practice Address - Phone:954-753-0500
Practice Address - Fax:954-753-0531
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9269207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI42295Medicare UPIN