# LEDER RETINA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Leder Retina & Uveitis Specialist
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609398916
- **Authorized official:** HENRY ALEXANDER LEDER MD (OWNER)
- **Authorized official phone:** (904) 201-9887

## Contact information

- **Practice address:** 13241 BARTRAM PARK BLVD UNIT 809, JACKSONVILLE, FL 32258-5216
- **Practice address phone:** (904) 201-9887
- **Practice address fax:** (904) 325-6434
- **Mailing address:** 332 N LOMBARDY LOOP, FRUIT COVE, FL 32259-5266
- **Mailing address phone:** (203) 520-7393

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | NULL | Yes |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | — | Yes |
| 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