Provider Demographics
NPI:1619191202
Name:EDWARD J LEONARD DC PA
Entity Type:Organization
Organization Name:EDWARD J LEONARD DC PA
Other - Org Name:FLORIDA WELLNESS & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-229-2225
Mailing Address - Street 1:101 N FRANKLIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5831
Mailing Address - Country:US
Mailing Address - Phone:813-229-2225
Mailing Address - Fax:
Practice Address - Street 1:101 N FRANKLIN ST STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-5831
Practice Address - Country:US
Practice Address - Phone:813-229-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9186111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty