Provider Demographics
NPI:1871939579
Name:TERMIN, LEON (MD)
Entity type:Individual
Prefix:
First Name:LEON
Middle Name:
Last Name:TERMIN
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 1:340 S PALM AVE
Mailing Address - Street 2:212
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-6723
Mailing Address - Country:US
Mailing Address - Phone:305-807-4480
Mailing Address - Fax:
Practice Address - Street 1:340 S PALM AVE
Practice Address - Street 2:212
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-6723
Practice Address - Country:US
Practice Address - Phone:305-807-4480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME11357207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D65609Medicare UPIN