MEDICARE: EMMA O'HALLORAN LEACH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME167307	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	TEOY7	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1063098549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMA O'HALLORAN LEACH MD

Provider Business Mailing Address
First Line	:	7717 COLLIER BLVD UNIT 202
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-2769
Country	:	US
Telephone Number	:	239-624-8300
Fax Number	:

Provider Business Practice Location Address
First Line	:	7717 COLLIER BLVD UNIT 202
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-2769
Country	:	US
Telephone Number	:	239-624-8300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2021
Last Update Date	:	08/28/2025

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Directions to “ EMMA O'HALLORAN LEACH MD” Practice Location

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