Individual
DR. LEONARDO B C BRASILIENSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1072 N LIBERTY ST STE 200, BOISE, ID 83704-8963
(208) 302-4100
(208) 302-4135
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 236-7051
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
M-17423
ID
207T00000X
Neurological Surgery Physician
MD61270647
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2213825
—
WA
Enumeration date
05/11/2015
Last updated
08/31/2023
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