=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972940690
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LEIGHTON AARON PEAVLER D.P.T.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2013
-----------------------------------------------------
Last Update Date | 03/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3700 ULMERTON RD STE 204
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33762-4235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-474-5225
-----------------------------------------------------
Fax | 727-624-6595
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3700 ULMERTON RD STE 204
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33762-4235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-490-8262
-----------------------------------------------------
Fax | 727-324-6595
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 188
-----------------------------------------------------
License Number State | VI
-----------------------------------------------------