| Deirdre Leake, MD | |
|
1750 Tree Blvd, Suite 10, St Augustine, FL 32084-5715 | |
| (904) 810-5434 | |
| (904) 810-5282 |
| Full Name | Deirdre Leake |
|---|---|
| Gender | Female |
| Speciality | Otolaryngology |
| Experience | 27 Years |
| Location | 1750 Tree Blvd, St Augustine, Florida |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073617585 | NPI | - | NPPES |
| P00255496 | Other | FL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | ME91018 (Florida) | Secondary |
| 207YS0123X | Otolaryngology - Facial Plastic Surgery | ME91018 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Flagler Hospital | Saint augustine, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Florida Ent Associates Inc | 4587556923 | 159 |
| Entity Name | Florida Ent Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184625733 PECOS PAC ID: 4587556923 Enrollment ID: O20040329001213 |
| Entity Name | N.f.l. Center For Oto-hns Facial Plastic Surgery P.a. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851325781 PECOS PAC ID: 8224061023 Enrollment ID: O20050913000553 |
| Mailing Address | Practice Location Address |
|---|---|
| Deirdre Leake, MD 15280 Nw 79th Ct Ste 200, Miami Lakes, FL 33016-5873 Ph: (305) 558-3724 | Deirdre Leake, MD 1750 Tree Blvd, Suite 10, St Augustine, FL 32084-5715 Ph: (904) 810-5434 |
Arthur Cortland Taliaferro, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 3 San Bartola Dr, St Augustine, FL 32086 Phone: 904-823-8823 Fax: 904-808-8587 | |
Robert Sean Miller, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 3 San Bartola Dr, St Augustine, FL 32086 Phone: 904-823-8823 Fax: 904-808-8587 | |
Uma Eyyunni, MD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 201 Health Park Blvd, Suite 107, St Augustine, FL 32086 Phone: 904-819-0101 | |
Bruce R Witten, M.D. Otolaryngology Medicare: Medicare Enrolled Practice Location: 301 Health Park Blvd, Suite 323, St Augustine, FL 32086 Phone: 904-829-6441 Fax: 904-829-2452 |