Healthcare Provider Details

I. General information

NPI: 1962294744
Provider Name (Legal Business Name): LEONARD DAVID CARLSON ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

936 BARCARMIL WAY
NAPLES FL
34110-0903
US

IV. Provider business mailing address

936 BARCARMIL WAY
NAPLES FL
34110-0903
US

V. Phone/Fax

Practice location:
  • Phone: 239-265-3391
  • Fax: 239-310-2035
Mailing address:
  • Phone: 239-265-3391
  • Fax: 239-310-2035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11039321
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: