Provider Demographics
NPI:1154018331
Name:NAEEM, LESLIE (APRN)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:NAEEM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 SLOUGH CREEK DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-9290
Mailing Address - Country:US
Mailing Address - Phone:781-752-9088
Mailing Address - Fax:
Practice Address - Street 1:2909 SLOUGH CREEK DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-9290
Practice Address - Country:US
Practice Address - Phone:781-752-9088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAG04230004363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care