Healthcare Provider Details

I. General information

NPI: 1508734112
Provider Name (Legal Business Name): LEIGHA S GORMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8895 N MILITARY TRAIL STE C-203
PALM BEACH GARDENS FL
33410
US

IV. Provider business mailing address

8895 N MILITARY TRAIL STE C-203
PALM BEACH GARDENS FL
33410
US

V. Phone/Fax

Practice location:
  • Phone: 772-310-8785
  • Fax:
Mailing address:
  • Phone: 772-310-8785
  • Fax: 949-561-5660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11043052
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: