NPI age
5 years
Enumerated 2020-11-14
● Active Type 2 · Organization
Subpart
Leodez
Leodez is 1 of 661 general practice organizations in Georgia.
Primary specialty
General Practice
Plus 2 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Mata
Owner
Last NPPES update
2020-11-14
Source: monthly bulk 2026-05
How this organization compares
Across 661 active general practice providers in Georgia.
NPI age
5 years
↓ 9 yr below median
Practice locations
1
0 secondary on file
Subspecialties
2
In the 35% of peers with subspecialties
NPI lifetime · 2020 → 2026
2020-11Enumerated in NPPES
2020
2026
Where they practice
Primary practice location
4292 Chamblee Tucker Rd
Tucker, GA 300842103
Mailing address
3899 Grassland Loop
Lake Mary, FL 327464120
Authorized official
Byron Oswaldo Mata, MD
Owner
📞 7864274450
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Betsnat Mengesha Physician Assistant NPI 1053279653
Specialties
-
General Practice PrimaryA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
-
Family MedicineThe NUCC recommends this code not be used. Choose a more appropriate code.
-
Family MedicineA family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Centro Medico San Lucas
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
Subpart of B Mata Llc.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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