Healthcare Provider Details

I. General information

NPI: 1346154754
Provider Name (Legal Business Name): KAREN LEONARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

647 SUNSET VIEW DR
DAVENPORT FL
33837-2668
US

IV. Provider business mailing address

3840 NW 83RD TER
CORAL SPRINGS FL
33065-2932
US

V. Phone/Fax

Practice location:
  • Phone: 954-544-9401
  • Fax:
Mailing address:
  • Phone: 754-367-5276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number14001076
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: