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General NPI Number Information
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NPI Number | 1881869709
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Entity Type | Individual
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Provider Name | DIANA Y LELAND
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Gender | Female
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 15000 CITRUS COUNTRY DR SUITE 212
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City | DADE CITY
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State | FL
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Zip | 33523
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Country | US
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Telephone | 813-469-1404
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Fax |
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Provider Business Mailing Address
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Address Line | 4744 TIMBER WAY
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City | ZEPHYRHILLS
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State | FL
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Zip | 33542-6518
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Country | US
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Telephone | 813-779-2362
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA41437
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License Number State | FL
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