Provider Demographics
NPI:1063640357
Name:FLORIO, LEIGH KIM (PA)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:KIM
Last Name:FLORIO
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2216 PRINCESS ANNE ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3300
Mailing Address - Country:US
Mailing Address - Phone:540-370-4380
Mailing Address - Fax:540-370-4201
Practice Address - Street 1:2216 PRINCESS ANNE ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3300
Practice Address - Country:US
Practice Address - Phone:540-370-4380
Practice Address - Fax:540-370-4201
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110002926363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant