Healthcare Provider Details
I. General information
NPI: 1205646445
Provider Name (Legal Business Name): TELEBP FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2025
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 SW 75TH ST STE 105
GAINESVILLE FL
32607-5775
US
IV. Provider business mailing address
100 SW 75TH ST STE 105
GAINESVILLE FL
32607-5775
US
V. Phone/Fax
- Phone: 317-919-2496
- Fax:
- Phone: 317-919-2496
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KEITH
LEONARD
MARCH
Title or Position: OWNER
Credential: MD, PHD
Phone: 317-919-2496