MEDICARE: MICHAEL LEE MCLEOD FNP-BC

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
1	207Q00000X	Family Medicine Physician	2025085252	VA

General Provider Information

NPI Number	:	1508716846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL LEE MCLEOD FNP-BC

Provider Business Mailing Address
First Line	:	3444 DAFFODIL CRES
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23453-2314
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3444 DAFFODIL CRES
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23453-2314
Country	:	US
Telephone Number	:	757-879-6453
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	03/18/2026

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