MEDICARE: JONISE M LEONARD LMA

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	225700000X	Massage Therapist	MA51473	FL

General Provider Information

NPI Number	:	1962967331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONISE M LEONARD LMA

Provider Business Mailing Address
First Line	:	7224 W COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-6743
Country	:	US
Telephone Number	:	407-440-4051
Fax Number	:	407-704-5981

Provider Business Practice Location Address
First Line	:	7224 W COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-6743
Country	:	US
Telephone Number	:	407-440-4051
Fax Number	:	407-704-5981

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

Provider Enumeration Date	:	02/09/2019
Last Update Date	:	02/09/2019

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Directions to “ JONISE M LEONARD LMA” Practice Location

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