Healthcare Provider Details

I. General information

NPI: 1376195370
Provider Name (Legal Business Name): LEONARDA M GAIGE APRN FNP-BC,PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 4TH ST N # 8419
ST PETERSBURG FL
33702-4305
US

IV. Provider business mailing address

7901 4TH ST N # 8419
ST PETERSBURG FL
33702-4305
US

V. Phone/Fax

Practice location:
  • Phone: 863-334-9037
  • Fax: 800-317-0709
Mailing address:
  • Phone: 863-334-9037
  • Fax: 800-317-0709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11003159
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11003159
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: