Provider Demographics
NPI:1235206483
Name:ZALSMAN, LEAH ROSE (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:LEAH
Middle Name:ROSE
Last Name:ZALSMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 N. MOUTAIN AVE BLDG F SUITE 128
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762
Mailing Address - Country:US
Mailing Address - Phone:909-949-9299
Mailing Address - Fax:
Practice Address - Street 1:3301 W GANDY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-2931
Practice Address - Country:US
Practice Address - Phone:813-925-1903
Practice Address - Fax:813-749-8370
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9116508363AM0700X
CAPA18711363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical