Healthcare Provider Details

I. General information

NPI: 1063668226
Provider Name (Legal Business Name): LEAH CHERNIN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2008
Last Update Date: 08/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3251 N MCMULLEN BOOTH RD STE 300
CLEARWATER FL
33761-2022
US

IV. Provider business mailing address

3251 N MCMULLEN BOOTH RD STE 300
CLEARWATER FL
33761-2022
US

V. Phone/Fax

Practice location:
  • Phone: 727-791-3337
  • Fax: 727-725-2577
Mailing address:
  • Phone: 727-791-3337
  • Fax: 727-725-2577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number34.009851
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberOS12883
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: