MEDICARE: MS. LESLEY ALLEN COOPER NP-C

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	363LF0000X	Family Nurse Practitioner	APRN9325010	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1942202684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LESLEY ALLEN COOPER NP-C

Provider Business Mailing Address
First Line	:	102 W PINELOCH AVE STE 23
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-6100
Country	:	US
Telephone Number	:	407-852-2760
Fax Number	:	321-843-6729

Provider Business Practice Location Address
First Line	:	102 W PINELOCH AVE STE 23
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-6100
Country	:	US
Telephone Number	:	407-852-2760
Fax Number	:	321-843-6729

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	01/08/2024

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