Provider Demographics
NPI:1225703887
Name:BANKS, LESLIE ANN SHEREE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE ANN
Middle Name:SHEREE
Last Name:BANKS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 WASHINGTON ST STE 305
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8249
Mailing Address - Country:US
Mailing Address - Phone:954-981-7070
Mailing Address - Fax:954-983-8510
Practice Address - Street 1:3700 WASHINGTON ST STE 305
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8249
Practice Address - Country:US
Practice Address - Phone:954-981-7070
Practice Address - Fax:954-983-8510
Is Sole Proprietor?:No
Enumeration Date:2021-08-14
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAG08210082363L00000X, 363LA2200X, 363LP2300X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1669242350OtherNPI