Healthcare Provider Details

I. General information

NPI: 1205618741
Provider Name (Legal Business Name): BRADEN HUNTER LEEK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2023
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6340 FORT KING RD
ZEPHYRHILLS FL
33542-2531
US

IV. Provider business mailing address

6340 FORT KING RD
ZEPHYRHILLS FL
33542-2531
US

V. Phone/Fax

Practice location:
  • Phone: 813-782-6116
  • Fax:
Mailing address:
  • Phone: 813-782-6116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9118085
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: