Provider Demographics
NPI:1023500303
Name:REMOLONA, LEA (MD)
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:
Last Name:REMOLONA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 CHAMPION BLVD
Mailing Address - Street 2:SUITE G-II BOX 231
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496
Mailing Address - Country:US
Mailing Address - Phone:786-563-3305
Mailing Address - Fax:916-581-8710
Practice Address - Street 1:5030 CHAMPION BLVD
Practice Address - Street 2:SUITE G-II 231
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496
Practice Address - Country:US
Practice Address - Phone:770-815-1962
Practice Address - Fax:916-581-8710
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-04
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME142014208D00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice