Provider Demographics
NPI:1447597620
Name:CANAS, LESLYE VANESSA (PA-C)
Entity Type:Individual
Prefix:
First Name:LESLYE
Middle Name:VANESSA
Last Name:CANAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LESLYE
Other - Middle Name:
Other - Last Name:CANAS-DEOLAZABAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1316 SONOMA CT
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-1517
Mailing Address - Country:US
Mailing Address - Phone:773-505-4473
Mailing Address - Fax:561-622-3375
Practice Address - Street 1:1316 SONOMA CT
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-1517
Practice Address - Country:US
Practice Address - Phone:773-505-4473
Practice Address - Fax:561-622-3375
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102733363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical