Provider Demographics
NPI:1780034181
Name:LELAND, RACHEL HIGGS (OD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:HIGGS
Last Name:LELAND
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9433 BALM RIVERVIEW RD STE 102
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-5120
Mailing Address - Country:US
Mailing Address - Phone:813-671-2020
Mailing Address - Fax:813-677-5549
Practice Address - Street 1:9433 BALM RIVERVIEW RD STE 102
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-5120
Practice Address - Country:US
Practice Address - Phone:813-671-2020
Practice Address - Fax:813-677-5549
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLOPC5630152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program