Healthcare Provider Details

I. General information

NPI: 1386755569
Provider Name (Legal Business Name): PATRICIA MURRAY LEAPLEY M.S.,R.D.,LD/N
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 NATIONAL HEALTH CARE DR
DAYTONA BEACH FL
32114-1495
US

IV. Provider business mailing address

3837 MARNIE PL
JACKSONVILLE FL
32223-3541
US

V. Phone/Fax

Practice location:
  • Phone: 386-323-7500
  • Fax: 386-323-7570
Mailing address:
  • Phone: 904-268-8075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number000649
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: