Basic Information
| Provider Information | |||||||||
| NPI: | 1235639543 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEON | ||||||||
| FirstName: | TONYA | ||||||||
| MiddleName: | MICHELL | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1146 SLEEPY OAK DR | ||||||||
| Address2: | |||||||||
| City: | WESLEY CHAPEL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335437173 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8137869551 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4315 HIGHLAND PARK BLVD | ||||||||
| Address2: | |||||||||
| City: | LAKELAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338131639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8638165884 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2018 | ||||||||
| LastUpdateDate: | 09/27/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | ARNP9290444 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.