Provider Demographics
NPI:1871785618
Name:LEONID REMENSON MD PA
Entity type:Organization
Organization Name:LEONID REMENSON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONID
Authorized Official - Middle Name:
Authorized Official - Last Name:REMENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-638-9219
Mailing Address - Street 1:5350 W ATLANTIC AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8112
Mailing Address - Country:US
Mailing Address - Phone:561-638-9219
Mailing Address - Fax:561-638-9221
Practice Address - Street 1:5350 W ATLANTIC AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8112
Practice Address - Country:US
Practice Address - Phone:561-638-9219
Practice Address - Fax:561-638-9221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL832732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8829Medicare PIN