Provider Demographics
NPI:1013026954
Name:EMHOF, LESLIE S (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:S
Last Name:EMHOF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 KILLEARN CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-3434
Mailing Address - Country:US
Mailing Address - Phone:850-893-6706
Mailing Address - Fax:850-893-2846
Practice Address - Street 1:1525 KILLEARN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-3434
Practice Address - Country:US
Practice Address - Phone:850-893-6706
Practice Address - Fax:850-893-2846
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME32694207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL37271ZMedicare ID - Type Unspecified
FLD85675Medicare UPIN