Most Relevant Information
Provider Data
| NPI Number: | 1003807181 |
| Provider Name: | LEO CZERVIONKE MD |
| Entity Type: | Individual |
| Taxonomy Code: | 2085R0202X |
| Specialty: | Radiology |
| License Number: | ME57587 |
Most Important Dates
| Enumeration Date: | 10/29/2005 |
| Last Updated: | 12/13/2017 |
Provider Practice Location
4500 SAN PABLO RD S
JACKSONVILLE
FL
322241865
Practice Location Phone/Fax
| Phone: | 9049532000 |
| Fax: |
Provider Mailing Location
4500 SAN PABLO RD S
JACKSONVILLE
FL
322241865
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |