Provider Demographics
NPI:1073007134
Name:LEONARD, WHITNEY RAYE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:RAYE
Last Name:LEONARD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7292 4TH ST N STE A
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-5813
Mailing Address - Country:US
Mailing Address - Phone:727-525-0895
Mailing Address - Fax:
Practice Address - Street 1:7292 4TH ST N STE A
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-5813
Practice Address - Country:US
Practice Address - Phone:727-525-0895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL33664225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist