Healthcare Provider Details

I. General information

NPI: 1457331142
Provider Name (Legal Business Name): KATHRYN HEGLAND LEENHOUTS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHRYN ANTEL MD

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 S KINGS AVE
BRANDON FL
33511-5921
US

IV. Provider business mailing address

PO BOX 748817
ATLANTA GA
30374-8817
US

V. Phone/Fax

Practice location:
  • Phone: 813-681-9171
  • Fax: 813-681-7580
Mailing address:
  • Phone: 813-286-0033
  • Fax: 813-282-1806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberME128504
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35077456L
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME128504
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: