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General NPI Number Information
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NPI Number | 1508354895
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Entity Type | Individual
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Provider Name | LESLIE BRUCE MD
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Gender | Female
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Dates
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Enumeration Date | 04/23/2018
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 225 E 7TH ST
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City | APOPKA
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State | FL
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Zip | 32703-5327
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Country | US
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Telephone | 407-905-8827
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Fax | 407-886-4282
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Provider Business Mailing Address
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Address Line | 110 S WOODLAND ST
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City | WINTER GARDEN
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State | FL
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Zip | 34787-3546
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Country | US
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Telephone | 407-905-8827
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Fax | 407-905-8998
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME142185
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME142185
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License Number State | FL
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