Provider Demographics
NPI:1245383207
Name:SLESNICK, LES M (RPH, CPH)
Entity Type:Individual
Prefix:MR
First Name:LES
Middle Name:M
Last Name:SLESNICK
Suffix:
Gender:M
Credentials:RPH, CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 WATERWITCH COVE CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-7851
Mailing Address - Country:US
Mailing Address - Phone:407-856-5434
Mailing Address - Fax:407-856-5434
Practice Address - Street 1:1230 WATERWITCH COVE CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-7851
Practice Address - Country:US
Practice Address - Phone:407-856-5434
Practice Address - Fax:407-856-5434
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS11154183500000X
FLPU1040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist