MEDICARE: LEANNE LENEE DRAGONE CRNP

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	363LA2200X	Adult Health Nurse Practitioner	SP008242	PA
2	363LA2200X	Adult Health Nurse Practitioner	APRN9390325	FL

General Provider Information

NPI Number	:	1790783660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEANNE LENEE DRAGONE CRNP

Provider Business Mailing Address
First Line	:	9009 CORPORATE LAKE DRIVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634
Country	:	US
Telephone Number	:	612-642-7442
Fax Number	:

Provider Business Practice Location Address
First Line	:	9009 CORPORATE LAKE DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-2367
Country	:	US
Telephone Number	:	612-642-7442
Fax Number	:

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	07/21/2022

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