Leesburg Regional Medical Center Physician Services LLC
NPI 1104063114ActiveOrganization· Emergency Medicine· Leesburg, FL
Emergency Medicine in Leesburg, Florida, registered in NPPES in January 2009. The authorized official on file is Heather Long, President, Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1104063114 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 13, 2009 |
| Last updated in NPPES | Nov 21, 2024 |
| Certified by provider | Nov 21, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Emergency Medicine Primary | 207P00000X | — | — |
| Psychiatry & Neurology, Neurology | 2084N0400X | ME102387 | FL |
| Surgery | 208600000X | ME101492 | FL |
| Surgery | 208600000X | ME062340 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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