Basic Information
| Provider Information | |||||||||
| NPI: | 1962530402 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAWKINS | ||||||||
| FirstName: | LEONARD | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 525 LITTLE LAKE CT | ||||||||
| Address2: | |||||||||
| City: | WINTER HAVEN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338843083 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8633261472 | ||||||||
| FaxNumber: | 8634227393 | ||||||||
| Practice Location | |||||||||
| Address1: | 455 EMERALD AVE | ||||||||
| Address2: | |||||||||
| City: | LAKE WALES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338534716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8636760014 | ||||||||
| FaxNumber: | 8636760900 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2007 | ||||||||
| LastUpdateDate: | 07/19/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA2840 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.