Healthcare Provider Details

I. General information

NPI: 1801960463
Provider Name (Legal Business Name): LEONARD STEVEN BAULING ARNP MN FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 04/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2830 BEE RIDGE RD
SARASOTA FL
34239-7115
US

IV. Provider business mailing address

1626 BROOKHOUSE DR APT BR235
SARASOTA FL
34231-1909
US

V. Phone/Fax

Practice location:
  • Phone: 941-927-1234
  • Fax: 941-921-0043
Mailing address:
  • Phone: 941-587-1148
  • Fax: 941-921-0043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN1309
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number264640-1806
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number07904246N1
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9465254
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9178533
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: