Provider Demographics
NPI:1528211919
Name:DUKE, LESLIE SUZANNE (DO)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:SUZANNE
Last Name:DUKE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:SUZANNE
Other - Last Name:BRIDGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10225 ULMERTON RD
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3538
Mailing Address - Country:US
Mailing Address - Phone:727-581-4849
Mailing Address - Fax:
Practice Address - Street 1:10225 ULMERTON RD
Practice Address - Street 2:1A
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-3538
Practice Address - Country:US
Practice Address - Phone:727-585-7408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10967207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine