MEDICARE: BARBARA ALVES LEAL

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1750036869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA ALVES LEAL

Provider Business Mailing Address
First Line	:	5660 BRIGHTON PARK LN APT 203
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-6068
Country	:	US
Telephone Number	:	754-367-1509
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 LEE RD STE 304
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-2101
Country	:	US
Telephone Number	:	321-765-4373
Fax Number	:

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

Provider Enumeration Date	:	02/16/2022
Last Update Date	:	10/27/2022

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