Individual
DR. ADAM ETHAN LEISY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 W 68TH ST, HIALEAH, FL 33016-1801
(305) 364-2124
Mailing address
700 SE 6TH CT, FORT LAUDERDALE, FL 33301-3114
(305) 788-4677
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301096939
MI
207P00000X
Emergency Medicine Physician
Primary
ME115884
FL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
ME115884
FL
Other
Enumeration date
07/08/2010
Last updated
07/23/2024
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