Provider Demographics
NPI:1215991369
Name:DONGELL, LESLIE LEIGH (MD)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:LEIGH
Last Name:DONGELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 N MCMULLEN BOOTH RD STE 201
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-3302
Mailing Address - Country:US
Mailing Address - Phone:727-725-5224
Mailing Address - Fax:727-799-2183
Practice Address - Street 1:2730 N MCMULLEN BOOTH RD STE 201
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-3302
Practice Address - Country:US
Practice Address - Phone:727-725-5224
Practice Address - Fax:727-799-2183
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87015207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003782000Medicaid
FL01531OtherBCBS
FL7311260OtherCIGNA
FL9391702OtherAETNA
FLK1130OtherMEDICARE GOUP
FL1091308OtherCAREPLUS
FLU2861WMedicare PIN
FLK1130OtherMEDICARE GOUP