Provider Demographics
NPI:1932148228
Name:LEONARD, DAVID R (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:LEONARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10134 BOTANICA DR
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33778-3437
Mailing Address - Country:US
Mailing Address - Phone:727-595-7948
Mailing Address - Fax:
Practice Address - Street 1:455 PINELLAS ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3354
Practice Address - Country:US
Practice Address - Phone:727-461-8300
Practice Address - Fax:727-461-8747
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME25407207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00250196OtherRAILROAD MEDICARE NUMBER
FL265867400Medicaid
FL78252UMedicare PIN
D58417Medicare UPIN