Provider Demographics
NPI:1336257757
Name:AMABILE, LEONARD
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:AMABILE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7404 PHILATELIC DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-6719
Mailing Address - Country:US
Mailing Address - Phone:352-686-0404
Mailing Address - Fax:
Practice Address - Street 1:7404 PHILATELIC DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-6719
Practice Address - Country:US
Practice Address - Phone:352-686-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLA514-520-43-100-0172A00000X
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered172A00000XOther Service ProvidersDriver
Not Answered174400000XOther Service ProvidersSpecialist