Provider Demographics
NPI:1437692647
Name:ELZEY, LEILA
Entity Type:Individual
Prefix:
First Name:LEILA
Middle Name:
Last Name:ELZEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 SARASOTA CENTER BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-9385
Mailing Address - Country:US
Mailing Address - Phone:941-379-3725
Mailing Address - Fax:941-377-1131
Practice Address - Street 1:63 SARASOTA CENTER BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-9385
Practice Address - Country:US
Practice Address - Phone:941-379-3725
Practice Address - Fax:941-377-1131
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics