Provider Demographics
NPI:1801885751
Name:LESCHER, THOMAS J (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:LESCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1940 NE 47TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-7711
Mailing Address - Country:US
Mailing Address - Phone:954-772-4553
Mailing Address - Fax:954-771-2372
Practice Address - Street 1:1940 NE 47TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-7711
Practice Address - Country:US
Practice Address - Phone:954-772-4553
Practice Address - Fax:954-771-2372
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME31566208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002630OtherNEIGHBORHOOD HEALTH
020012678OtherRAILROAD RETIREMENT
4106169OtherAETNA
FLE14553OtherVISTA
FL215157OtherAVMED
FL93799OtherBLUE CROSS BLUE SHIELD
93799ZMedicare ID - Type Unspecified
020012678OtherRAILROAD RETIREMENT