Provider Demographics
NPI:1306899315
Name:LEISURE SOLUTIONS, INC.
Entity type:Organization
Organization Name:LEISURE SOLUTIONS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JACQUES
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-751-0235
Mailing Address - Street 1:13940 N US HIGHWAY 441
Mailing Address - Street 2:SUITE 905
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-8908
Mailing Address - Country:US
Mailing Address - Phone:352-751-0235
Mailing Address - Fax:352-751-6777
Practice Address - Street 1:13940 N US HIGHWAY 441
Practice Address - Street 2:SUITE 905
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-8908
Practice Address - Country:US
Practice Address - Phone:352-751-0235
Practice Address - Fax:352-751-6777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5021291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2230264OtherFIRST HEALTH
FL278869OtherHEALTHEASE
FLF01321OtherFREEDOM HEALTH
FL05641OtherUNITED HEALTH CARE
FL06541OtherUNIVERSAL HEALTHCARE
FL3679125OtherAETNA HMO
FL7936611OtherAETNA PPO
FLV2891OtherBCBS
FL06541OtherUNIVERSAL HEALTHCARE
FL278869OtherHEALTHEASE
FL=========OtherBEECHSTREET
FL=========OtherGREAT WEST
FLF01321OtherFREEDOM HEALTH
FL=========OtherPED-I-CARE
FLV2891OtherBCBS