Provider Demographics
NPI:1700983434
Name:LEONARD, EDWARD J (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:J
Last Name:LEONARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 N FRANKLIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5831
Mailing Address - Country:US
Mailing Address - Phone:813-229-2225
Mailing Address - Fax:813-221-2225
Practice Address - Street 1:101 N FRANKLIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-5831
Practice Address - Country:US
Practice Address - Phone:813-229-2225
Practice Address - Fax:813-221-2225
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2014-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9186111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor