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Individual

LEONARD R CACIOPPO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
14543 CORTEZ BLVD, BROOKSVILLE, FL 34613-6065
(352) 596-4030
(352) 596-1997
Mailing address
14543 CORTEZ BLVD, BROOKSVILLE, FL 34613-6065
(352) 596-4030
(352) 596-1997

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME035752
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00008818
ADVANTICA
FL
05
038281700
FL
Enumeration date
11/14/2006
Last updated
02/08/2010
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