Individual
ILYA M LEYNGOLD
Active
Individual
ILYA M LEYNGOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
ME112787
FL
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
2016-00134
NC
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
M-15568
ID
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
ME112787
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005984000
—
FL
01
—
14L01
BLUE CROSS BLUE SHIELD
FL
01
—
20024216
MEDICARE
ID
Enumeration date
02/08/2007
Last updated
04/08/2026
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