Provider Demographics
NPI:1164538526
Name:HORNE, LESLIE LEANORA (DC)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:LEANORA
Last Name:HORNE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 RADEN DR
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-5105
Mailing Address - Country:US
Mailing Address - Phone:813-948-2225
Mailing Address - Fax:813-949-7029
Practice Address - Street 1:2414 RADEN DR
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-5105
Practice Address - Country:US
Practice Address - Phone:813-948-2225
Practice Address - Fax:813-949-7029
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2864111N00000X
FLCH11248111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085C4OtherBCBS
NC45732OtherPARTNERS
NC89085C4Medicaid
NC89085C4Medicaid