Provider Demographics
NPI:1801960463
Name:BAULING, LEONARD STEVEN (ARNP MN FNP)
Entity type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:STEVEN
Last Name:BAULING
Suffix:
Gender:M
Credentials:ARNP MN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1626 BROOKHOUSE DR APT BR235
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-1909
Mailing Address - Country:US
Mailing Address - Phone:941-587-1148
Mailing Address - Fax:941-921-0043
Practice Address - Street 1:2830 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-7115
Practice Address - Country:US
Practice Address - Phone:941-927-1234
Practice Address - Fax:941-921-0043
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN1309363LF0000X
CA264640-1806363LF0000X
OR07904246N1363LF0000X
FLARNP9465254363LF0000X
FLARNP9178533363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR167822OtherMEDICARE PTAN
FL308774300Medicaid
HIFM388ZOtherPTAN
FL308774300Medicaid
HIFM388ZOtherPTAN