Provider Demographics
NPI:1821169434
Name:LEONARD, STEPHEN J (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:LEONARD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4015 MARINER BLVD
Mailing Address - Street 2:FLORIDA FOOT & ANKLE CENTER PA
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-2720
Mailing Address - Country:US
Mailing Address - Phone:352-688-9558
Mailing Address - Fax:352-683-6837
Practice Address - Street 1:4015 MARINER BLVD
Practice Address - Street 2:FLORIDA FOOT & ANKLE CENTER PA
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-2720
Practice Address - Country:US
Practice Address - Phone:352-688-9558
Practice Address - Fax:352-683-6837
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP00002024213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65143OtherBLUE CROSS BLUE SHIELD
FL2649714633OtherAUMED
FL6200023OtherGHI
FL2649714633OtherAUMED
FL65143OtherBLUE CROSS BLUE SHIELD