MEDICARE: DAVID H LEACH 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	207W00000X	Ophthalmology Physician	ME0062591	FL

General Provider Information

NPI Number	:	1568454320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID H LEACH M.D.

Provider Business Mailing Address
First Line	:	3000 W DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6308
Country	:	US
Telephone Number	:	813-877-2020
Fax Number	:	813-872-7387

Provider Business Practice Location Address
First Line	:	3000 W DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6308
Country	:	US
Telephone Number	:	813-877-2020
Fax Number	:	813-872-7387

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	07/08/2007

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Directions to “ DAVID H LEACH M.D.” Practice Location

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