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NPI Code Detail

MEDICARE: JOHN L LEY PA-C

MEDICARE: JOHN L LEY PA-C
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
1363AM0700XMedical Physician AssistantPA2591FL

General Provider Information

NPI Number : 1164478053
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN L LEY PA-C
Provider Business Mailing Address
First Line : 1340 TUSKAWILLA RD
Second Line : SUITE 101-105
City : WINTER SPRINGS
State : FL
Zip : 32708-5030
Country : US
Telephone Number : 407-699-1160
Fax Number : 407-699-7861
Provider Business Practice Location Address
First Line : 1340 TUSKAWILLA RD
Second Line : SUITE 101-105
City : WINTER SPRINGS
State : FL
Zip : 32708-5030
Country : US
Telephone Number : 407-699-1160
Fax Number : 407-699-7861
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 08/17/2007

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Directions to “ JOHN L LEY PA-C” Practice Location

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