Provider Demographics
NPI:1952638041
Name:MUNROE, COURTLAND LEROY (MD)
Entity Type:Individual
Prefix:DR
First Name:COURTLAND
Middle Name:LEROY
Last Name:MUNROE
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 1:918 ROLLING ACRES RD
Mailing Address - Street 2:STE 1
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-5026
Mailing Address - Country:US
Mailing Address - Phone:352-787-8489
Mailing Address - Fax:
Practice Address - Street 1:1210 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-4935
Practice Address - Country:US
Practice Address - Phone:352-787-8489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLL692207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine