Basic Information
| Provider Information | |||||||||
| NPI: | 1356488654 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLOREK | ||||||||
| FirstName: | LEANNE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LAC DOM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1010 CENTRAL AVE APT 110 | ||||||||
| Address2: | |||||||||
| City: | SAINT PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337056651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9412243717 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1745 S HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275870377 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2007 | ||||||||
| LastUpdateDate: | 11/26/2019 | ||||||||
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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 | 171100000X | AP2213 | FL | Y | Other Service Providers | Acupuncturist |
No ID Information.