Provider Demographics
NPI:1649702291
Name:VOLPE, LEONARD (SA-C, RNFA)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:VOLPE
Suffix:
Gender:M
Credentials:SA-C, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 PORTA ROSA CIR
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-0476
Mailing Address - Country:US
Mailing Address - Phone:727-514-1188
Mailing Address - Fax:
Practice Address - Street 1:745 PORTA ROSA CIR
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092
Practice Address - Country:US
Practice Address - Phone:727-514-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL01-158163WR0006X, 364S00000X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist