Healthcare Provider Details

I. General information

NPI: 1932370491
Provider Name (Legal Business Name): LESLIE CAROL MILOS ARNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2008
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 MASON AVE
DAYTONA BEACH FL
32117-4549
US

IV. Provider business mailing address

784 S RIDGEWOOD AVE
ORMOND BEACH FL
32174-7655
US

V. Phone/Fax

Practice location:
  • Phone: 386-274-2090
  • Fax: 386-274-2009
Mailing address:
  • Phone: 386-299-0918
  • Fax: 386-274-2009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP 2797782
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: