Provider Demographics
NPI:1952300097
Name:LEIZMAN, DANIEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:LEIZMAN
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 1:2623 S SEACREST BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7532
Mailing Address - Country:US
Mailing Address - Phone:561-620-1653
Mailing Address - Fax:561-395-4551
Practice Address - Street 1:2623 S SEACREST BLVD STE 216
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7532
Practice Address - Country:US
Practice Address - Phone:561-734-5080
Practice Address - Fax:561-364-1849
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-063098208100000X
FLME102427208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH250004657OtherMEDICARE RR
OH0892351Medicaid
OH23-00125OtherUNITED HEALTH CARE
OH000000126901OtherANTHEM
OH000000126901OtherANTHEM
OH23-00125OtherUNITED HEALTH CARE
OH7420671Medicare PIN