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Individual

DR. DWAYNE FELIX LEDESMA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8141 BELLARUS WAY, SUITE 102, TRINITY, FL 34655-1783
(727) 845-3555
(727) 842-3556
Mailing address
8141 BELLARUS WAY, SUITE 102, TRINITY, FL 34655-1783
(727) 845-3555
(727) 842-3556

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME 80320
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2504815
AETNA HMO
FL
05
266333300
FL
01
51708
BC/BS OF FL #
FL
01
5519719
AETNA PPO
FL
01
592523434
CIGNA, UNITED, GHI
FL
01
98621
BC/BS OF FL GROUP #
FL
Enumeration date
01/04/2006
Last updated
04/10/2014
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