Provider Demographics
NPI:1932318409
Name:BARNES, LESLIE JEANNE (MS, PT, ATC/LAT CSCS)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:JEANNE
Last Name:BARNES
Suffix:
Gender:F
Credentials:MS, PT, ATC/LAT CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11209 NW 35TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-4993
Mailing Address - Country:US
Mailing Address - Phone:352-219-7788
Mailing Address - Fax:
Practice Address - Street 1:1 FLETCHER DRIVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-7500
Practice Address - Country:US
Practice Address - Phone:352-294-7402
Practice Address - Fax:352-392-5025
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19829225100000X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer