Provider Demographics
NPI:1881869709
Name:LELAND, DIANA Y
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:Y
Last Name:LELAND
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 1:4744 TIMBER WAY
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-6518
Mailing Address - Country:US
Mailing Address - Phone:813-779-2362
Mailing Address - Fax:
Practice Address - Street 1:15000 CITRUS COUNTRY DR
Practice Address - Street 2:SUITE 212
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33523
Practice Address - Country:US
Practice Address - Phone:813-469-1404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA41437225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist