Provider Demographics
NPI:1619904380
Name:PINCUS, LEIGH ANN (ARNP)
Entity Type:Individual
Prefix:MS
First Name:LEIGH
Middle Name:ANN
Last Name:PINCUS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:ANNA
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-273-9000
Mailing Address - Fax:352-392-8413
Practice Address - Street 1:1600 SW ARCHER ROAD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0371
Practice Address - Country:US
Practice Address - Phone:352-273-9000
Practice Address - Fax:352-392-8413
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2944622363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304583800Medicaid
FLY1078ZMedicare PIN
P62448Medicare UPIN
FL304583800Medicaid