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Individual

LES R FOLIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
17327 LADERA ESTATES BLVD, LUTZ, FL 33548-4817
(813) 745-7365
(813) 449-8618
Mailing address
PO BOX 198441, ATLANTA, GA 30384-8441

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
0102201831
VA
2085N0700X
Neuroradiology Physician
0102201831
VA
2085N0904X
Nuclear Radiology Physician
0102201831
VA
2085P0229X
Pediatric Radiology Physician
0102201831
VA
2085R0202X
Diagnostic Radiology Physician
0102201831
VA
2085R0202X
Diagnostic Radiology Physician
Primary
OS18152
FL
2085R0204X
Vascular & Interventional Radiology Physician
0102201831
VA
2085U0001X
Diagnostic Ultrasound Physician
0102201831
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0097
CAREFIRST BCBS
VA
Enumeration date
07/10/2006
Last updated
01/08/2024
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