Provider Demographics
NPI:1922148170
Name:DARBY, LESLIE ANN II
Entity Type:Individual
Prefix:MR
First Name:LESLIE
Middle Name:ANN
Last Name:DARBY
Suffix:II
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1786 17TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32962-6871
Mailing Address - Country:US
Mailing Address - Phone:407-256-0722
Mailing Address - Fax:
Practice Address - Street 1:100 S US HIGHWAY 1
Practice Address - Street 2:SUITE 6
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32962-3630
Practice Address - Country:US
Practice Address - Phone:772-562-8279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL15922255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer