Provider Demographics
NPI:1508302563
Name:MCDONALD, LESLEY (PT)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LESLEY
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:3200 BAILEY LN STE 117
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-8506
Mailing Address - Country:US
Mailing Address - Phone:239-431-9650
Mailing Address - Fax:239-431-9649
Practice Address - Street 1:3200 BAILEY LN STE 117
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-8506
Practice Address - Country:US
Practice Address - Phone:239-431-9650
Practice Address - Fax:239-431-9649
Is Sole Proprietor?:No
Enumeration Date:2017-01-16
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT321182251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic