LEESBURG REGIONAL MEDICAL CENTER PHYSICIAN SERVICES LLC
NPI 1104063114
Emergency Medicine in Leesburg, FL
NPI Status: Active since January 13, 2009
Contact Information
600 E DIXIE AVE
LEESBURG, FL
ZIP 34748
Phone: (523) 594-0827
Fax: (352) 323-5039
- Organization
- Emergency Medicine
- Accepts Insurance
- CLIA Number: 10D0870713
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 08-31-2026
About LEESBURG REGIONAL MEDICAL CENTER PHYSICIAN SERVICES LLC
This page provides the complete NPI Profile along with additional information for Leesburg Regional Medical Center Physician Services Llc, a provider established in Leesburg, Florida operating as a Emergency Medicine. The healthcare provider is registered in the NPI registry with number 1104063114 assigned on January 2009. The practitioner's primary taxonomy code is 207P00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Leesburg Regional Medical Center Physician Services Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mrs. Heather Long (President, Ceo)
- NPI
- 1104063114
- Provider Name
- LEESBURG REGIONAL MEDICAL CENTER PHYSICIAN SERVICES LLC
- Entity Type
- Organization
- Location Address
- 600 E DIXIE AVE LEESBURG, FL 34748
- Location Phone
- (523) 594-0827
- Location Fax
- (352) 323-5039
- Mailing Address
- 600 E DIXIE AVE LEESBURG, FL 34748
- Mailing Phone
- (352) 323-5002
- Mailing Fax
- (352) 323-5039
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-13-2009
- Last Update Date
- 11-21-2024
- Code Navigator
Location Map
Secondary Locations
- 17021 US Highway 441
Mount Dora, FL 32757
(523) 594-0827
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Emergency Medicine
- Taxonomy Code
- 207P00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | ME102387 (FL) |
| 2 | 208600000X | Allopathic & Osteopathic Physicians | Surgery | ME101492 (FL) |
| 3 | 208600000X | Allopathic & Osteopathic Physicians | Surgery | ME062340 (FL) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Molina Bronze Enhanced 3500 - HMO
- Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision - HMO
- Molina Bronze Enhanced 3500 Plus with Adult Vision - HMO
- Molina Bronze Premier with $0 Medical Deductible - HMO
- Molina Bronze Premier with $0 Medical Deductible Plus with Adult Dental and Vision - HMO
- Molina Bronze Premier with $0 Medical Deductible Plus with Adult Vision - HMO
- Molina Bronze Standard - HMO
- Molina Gold Core 1640 - HMO
- Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
- Molina Gold Core 1640 Plus with Adult Vision - HMO
- Molina Gold Enhanced 895 - HMO
- Molina Gold Enhanced 895 Plus with Adult Dental and Vision - HMO
- Molina Gold Enhanced 895 Plus with Adult Vision - HMO
- Molina Gold Standard - HMO
- Molina Silver Access - HMO
- Molina Silver Access Plus with Adult Dental and Vision - HMO
- Molina Silver Access Plus with Adult Vision - HMO
- Molina Silver Core - HMO
- Molina Silver Core Plus with Adult Dental and Vision - HMO
- Molina Silver Core Plus with Adult Vision - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D0870713
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- PAUL W. JUENG
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Leesburg Regional Medical Center Physician Services Llc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1104063114, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 46. The final step is to find the difference between that total and the next multiple of ten (50 - 46 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 46 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
LEESBURG, FL 34748
LEESBURG, FL 34748
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104063114, enumerated as an "organization" on January 13, 2009.
The provider is located at 600 E DIXIE AVE LEESBURG, FL 34748 and the phone number is (523) 594-0827.
Emergency Medicine with taxonomy code 207P00000X.
The provider might be accepting Accepts: Molina Healthcare. Please consult your insurance carrier or call the provider to verify.
