Healthcare Provider Details

I. General information

NPI: 1437692647
Provider Name (Legal Business Name): LEILA ELZEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 11/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 SARASOTA CENTER BLVD STE 101
SARASOTA FL
34240-9385
US

IV. Provider business mailing address

63 SARASOTA CENTER BLVD STE 101
SARASOTA FL
34240-9385
US

V. Phone/Fax

Practice location:
  • Phone: 941-379-3725
  • Fax: 941-377-1131
Mailing address:
  • Phone: 941-379-3725
  • Fax: 941-377-1131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: