Provider Demographics
NPI:1174538896
Name:CALODNEY, LEONARD (MD)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:CALODNEY
Suffix:
Gender:M
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:PO BOX 742318
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2103
Mailing Address - Country:US
Mailing Address - Phone:317-614-9863
Mailing Address - Fax:844-876-0873
Practice Address - Street 1:6201 N SUNCOAST BLVD
Practice Address - Street 2:C/O SEVEN RIVERS REGIONAL
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34428-6712
Practice Address - Country:US
Practice Address - Phone:352-795-4008
Practice Address - Fax:352-795-9041
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME016821207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056460500Medicaid
FL92296Medicare ID - Type Unspecified
D60025Medicare UPIN