Provider Demographics
NPI:1750036869
Name:LEAL, BARBARA ALVES
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ALVES
Last Name:LEAL
Suffix:
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 1:5660 BRIGHTON PARK LN APT 203
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-6068
Mailing Address - Country:US
Mailing Address - Phone:754-367-1509
Mailing Address - Fax:
Practice Address - Street 1:1801 LEE RD STE 304
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2101
Practice Address - Country:US
Practice Address - Phone:321-765-4373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-16
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant