Provider Demographics
NPI:1952350720
Name:MEAD, LEON PAUL (MD)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:PAUL
Last Name:MEAD
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 1:730 GOODLETTE RD N
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5616
Mailing Address - Country:US
Mailing Address - Phone:239-262-1119
Mailing Address - Fax:239-262-2657
Practice Address - Street 1:730 GOODLETTE RD N
Practice Address - Street 2:SUITE 201
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5616
Practice Address - Country:US
Practice Address - Phone:239-262-1119
Practice Address - Fax:239-262-2657
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME54962207X00000X, 207XS0114X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL08925ZMedicare PIN
FLD44252Medicare UPIN