Organization
LEONID B TROST MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONID B TROST MD (MD/OWNER)
(239) 482-7546
Entity
Organization
Contact information
Practice address
9400 GLADIOLUS DR, STE 320, FORT MYERS, FL 33908-6699
(239) 482-7546
(239) 243-8648
Mailing address
9400 GLADIOLUS DR, STE 320, FORT MYERS, FL 33908-6699
(239) 482-7546
(239) 243-8648
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
ME100046
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME100046
STATE MEDICAL LICENSE
FL
Enumeration date
07/23/2012
Last updated
07/31/2012
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