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Organization
LEDER RETINA
Active
Organization
LEDER RETINA
Active
Other names
Leder Retina & Uveitis Specialist
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY ALEXANDER LEDER MD (OWNER)
(904) 201-9887
Entity
Organization
Contact information
Practice address
13241 BARTRAM PARK BLVD UNIT 809, JACKSONVILLE, FL 32258-5216
(904) 201-9887
(904) 325-6434
Mailing address
332 N LOMBARDY LOOP, FRUIT COVE, FL 32259-5266
(203) 520-7393
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
NULL
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
207WX0108X
Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
—
NULL
207WX0108X
Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
—
—
261Q00000X
Clinic/Center
D64669
MD
261QS0132X
Ophthalmologic Surgery Clinic/Center
D64669
MD
Other
Enumeration date
07/10/2017
Last updated
04/02/2020
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