Provider Demographics
NPI:1174582464
Name:LEFLER, JAMES EMILIO (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EMILIO
Last Name:LEFLER
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 1:2700 HEALING WAY
Mailing Address - Street 2:STE 320
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-5453
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6748 GALL BLVD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-2544
Practice Address - Country:US
Practice Address - Phone:813-783-8378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME827752085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL118708Medicaid
FL300121088OtherRR MEDICARE
FL300125444OtherRR MEDICARE
FL300121089OtherRR MEDICARE
FL261695500Medicaid
FL300121090OtherRR MEDICARE
FL01843VMedicare PIN
FL08143UMedicare PIN
FL300121088OtherRR MEDICARE
FL300121090OtherRR MEDICARE
FL01843TMedicare PIN
FL300121089OtherRR MEDICARE
FL01843XMedicare PIN
FL01843Medicare PIN