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Individual

DR. LEONARD JAY SHUKOVSKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6927 GREENTREE DR, NAPLES, FL 34108-8528
(239) 591-4138
Mailing address
6927 GREENTREE DR, NAPLES, FL 34108-8528
(239) 591-4138

Taxonomy

Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
ME 24906
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ME 24906
STATE MEDICAL LICENSE
FL
Enumeration date
10/27/2012
Last updated
10/27/2012
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