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NPI Code Detail

MEDICARE: GARY L LEFFELMAN ARNP

MEDICARE: GARY L LEFFELMAN ARNP
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
1363L00000XNurse PractitionerARNP2037292FL

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 : 1952369928
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY L LEFFELMAN ARNP
Provider Business Mailing Address
First Line : 6520 FORT CAROLINE RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32277-2044
Country : US
Telephone Number : 904-744-7300
Fax Number : 904-722-4271
Provider Business Practice Location Address
First Line : 6339 ARGYLE FOREST BLVD STE 2
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32244-6601
Country : US
Telephone Number : 904-777-6228
Fax Number : 904-777-6722
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 03/31/2015

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