Healthcare Provider Details

I. General information

NPI: 1194265710
Provider Name (Legal Business Name): LINDSEY R. LEESON, M.S., CCC-SLP, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2017
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37937 HEATHER PL
DADE CITY FL
33525-5420
US

IV. Provider business mailing address

37937 HEATHER PL
DADE CITY FL
33525-5420
US

V. Phone/Fax

Practice location:
  • Phone: 352-467-0088
  • Fax: 813-779-1879
Mailing address:
  • Phone: 352-467-0088
  • Fax: 813-779-1879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA11458
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUSANNE WITT
Title or Position: ADMIN MANAGER
Credential:
Phone: 352-585-7871