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General NPI Number Information
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NPI Number | 1831508506
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Entity Type | Organization
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Legal Business Name | METABOLIC MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 08/07/2014
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Last Update Date | 01/26/2017
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Provider Practice Location Address
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Address Line | 1120 BELCHER RD S SUITE 2
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City | LARGO
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State | FL
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Zip | 33771-3315
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Country | US
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Telephone | 727-826-0838
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Fax | 877-275-8431
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Provider Business Mailing Address
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Address Line | 1120 BELCHER RD S SUITE 2
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City | LARGO
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State | FL
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Zip | 33771-3315
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Country | US
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Telephone | 727-826-0838
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Fax | 877-275-8431
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Authorized Official
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Title or Position | OWNER
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Name | DR. TRACIE JEAN LEONHARDT
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Credential | D.O.
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Telephone | 727-826-0838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | OS6672
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | OS6672
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License Number State | FL
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