Healthcare Provider Details

I. General information

NPI: 1386939452
Provider Name (Legal Business Name): JAMES F LEITERA NURSE PRACTITIONER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2011
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 S 23RD ST STE 1
FORT PIERCE FL
34950-4830
US

IV. Provider business mailing address

3627 SW SUNSET TRACE CIR
PALM CITY FL
34990-3035
US

V. Phone/Fax

Practice location:
  • Phone: 800-735-1178
  • Fax: 772-223-6354
Mailing address:
  • Phone: 724-971-3329
  • Fax: 772-223-6354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN9486122
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9486122
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: