Provider Demographics
NPI:1346329703
Name:LEONARD, GAYANI (MD)
Entity Type:Individual
Prefix:
First Name:GAYANI
Middle Name:
Last Name:LEONARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3665 EMBASSY CIR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-1017
Mailing Address - Country:US
Mailing Address - Phone:727-786-2149
Mailing Address - Fax:
Practice Address - Street 1:3135 STATE ROAD 580
Practice Address - Street 2:SUITE NUMBER 14
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-4976
Practice Address - Country:US
Practice Address - Phone:727-791-0511
Practice Address - Fax:727-791-3331
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00741002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG13151Medicare UPIN