Individual
DR. LEONARDO MIGUEL ANTARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1230 E RUSHOLME ST, SUITE 107, DAVENPORT, IA 52803-2400
(563) 326-8181
(563) 326-8184
Mailing address
1230 E RUSHOLME ST, SUITE 107, DAVENPORT, IA 52803-2400
(563) 326-8181
(563) 326-8184
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036092359
IL
207W00000X
Ophthalmology Physician
Primary
27394
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0293464
—
IA
Enumeration date
03/10/2006
Last updated
06/21/2010
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