MEDICARE: DR. LESLIE MILTON O'STEEN M.D.

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	207L00000X	Anesthesiology Physician	ME 20878	FL

General Provider Information

NPI Number	:	1548270903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLIE MILTON O'STEEN M.D.

Provider Business Mailing Address
First Line	:	563 POCAHONTAS DR
Second Line	:
City	:	FT WALTON BCH
State	:	FL
Zip	:	32547-3220
Country	:	US
Telephone Number	:	850-862-1200
Fax Number	:

Provider Business Practice Location Address
First Line	:	563 POCAHONTAS DR
Second Line	:
City	:	FT WALTON BCH
State	:	FL
Zip	:	32547-3220
Country	:	US
Telephone Number	:	850-862-1200
Fax Number	:

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	07/08/2007

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