Provider Demographics
NPI:1427570241
Name:WISNIEWSKI, LEONARD P (RRT)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:P
Last Name:WISNIEWSKI
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34332 APPALOOSA TRL
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-5072
Mailing Address - Country:US
Mailing Address - Phone:813-892-4774
Mailing Address - Fax:
Practice Address - Street 1:2435 US HIGHWAY 19 STE 300
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-3909
Practice Address - Country:US
Practice Address - Phone:727-940-5908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT12125227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered