Provider Demographics
NPI:1902483985
Name:BRIAN C LEUNG MD-CENTRAL FLORIDA BONE AND JOINT INSTITUTE, PLLC
Entity Type:Organization
Organization Name:BRIAN C LEUNG MD-CENTRAL FLORIDA BONE AND JOINT INSTITUTE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-775-2012
Mailing Address - Street 1:2745 REBECCA LN
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8333
Mailing Address - Country:US
Mailing Address - Phone:386-775-2012
Mailing Address - Fax:386-775-2013
Practice Address - Street 1:917 RINEHART RD STE 2031
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-4806
Practice Address - Country:US
Practice Address - Phone:386-775-2012
Practice Address - Fax:386-775-2013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-25
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7731050003OtherDMERC SUPPLIER PTAN