Leisure World of Maryland, Corp.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

LEISURE WORLD OF MARYLAND, CORP.

Practice address

3305 N Leisure World Blvd
Silver Spring, MD 20906-1367

Phone

(301) 598-1590

Fax

(301) 598-1569

NPI assigned

Jun 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Virginia Bronaugh

Title

Administrator

Phone

(301) 598-1550

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Leisure World Medical Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326076894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 N LEISURE WORLD BLVD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209061367",
            "telephone_number": "301-598-1590",
            "fax_number": "301-598-1569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 N LEISURE WORLD BLVD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209061367",
            "telephone_number": "301-598-1590",
            "fax_number": "301-598-1569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEISURE WORLD OF MARYLAND, CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRONAUGH",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "301-598-1550"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUE SHIELD",
            "identifier": "B773",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA5483",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leisure World Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Legacy&Gas, LLC
• Amare Legesse, MLS
• Seniat Legesse
• Rhonda Sue Lehman, LCSW-C
• Michael E Leibowitz, M.D.
• Leisure World of MD Corp
• Leisure World Opticians Inc
• Leisure World Opticians, Inc.
• Carol Vanessa Leiva, LCPC
• Rona Mae Labatete Lejarde, PT

• Geriatric Medicine (Internal Medicine) Physician in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Geriatric Medicine (Internal Medicine) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.