Provider Demographics
NPI:1861419392
Name:LANDY, HOWARD J (MD, FACS)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:J
Last Name:LANDY
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Gender:M
Credentials:MD, FACS
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Mailing Address - Street 1:1095 NW 14TH TERRACE
Mailing Address - Street 2:LOIS POPE LIFE CENTER
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136
Mailing Address - Country:US
Mailing Address - Phone:305-243-6946
Mailing Address - Fax:305-243-3337
Practice Address - Street 1:1095 NW 14TH TERRACE
Practice Address - Street 2:LOIS POPE LIFE CENTER
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-243-6946
Practice Address - Fax:305-243-3337
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2020-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME39194207T00000X
FLME0039194207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0435406-00Medicaid
FL043540600Medicaid
FLD54290Medicare UPIN
FL34053Medicare UPIN
FL34053ZMedicare UPIN