Provider Demographics
NPI:1538513585
Name:JAVIDI, LEILA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:LEILA
Middle Name:MARIE
Last Name:JAVIDI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1121 WORTHINGTON WOODS BLVD # 6008
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43085-1568
Mailing Address - Country:US
Mailing Address - Phone:216-316-0760
Mailing Address - Fax:833-428-9434
Practice Address - Street 1:1121 WORTHINGTON WOODS BLVD # 6008
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43085-1568
Practice Address - Country:US
Practice Address - Phone:216-316-0760
Practice Address - Fax:833-428-9434
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-15
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.136524207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine