Provider Demographics
NPI:1831136233
Name:FLEMENS, NATASHA LEONTINE (MD)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:LEONTINE
Last Name:FLEMENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 W DR MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6303
Mailing Address - Country:US
Mailing Address - Phone:813-684-2229
Mailing Address - Fax:813-816-0326
Practice Address - Street 1:2701 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6303
Practice Address - Country:US
Practice Address - Phone:136-842-2298
Practice Address - Fax:813-813-0326
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86232207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273094400Medicaid
G93088Medicare UPIN
FL273094400Medicaid
FL273094400Medicaid