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NPI Code Detail

MEDICARE: LEONGER MALPICA APRN

MEDICARE: LEONGER MALPICA APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse Practitioner11001728FL
2363LA2200XAdult Health Nurse Practitioner11001728FL
3363LG0600XGerontology Nurse Practitioner11001728FL
4363L00000XNurse Practitioner11001728FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457819625
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEONGER MALPICA APRN
Provider Business Mailing Address
First Line : PO BOX 198441
Second Line :
City : ATLANTA
State : GA
Zip : 30384-8441
Country : US
Telephone Number : 813-745-4673
Fax Number : 813-449-8618
Provider Business Practice Location Address
First Line : 12902 USF MAGNOLIA DR
Second Line :
City : TAMPA
State : FL
Zip : 33612-9416
Country : US
Telephone Number : 813-745-8442
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2019
Last Update Date : 05/05/2026

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