Provider Demographics
NPI:1386806420
Name:PARIS-WADE, LEANNE (CRNA)
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:PARIS-WADE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LEANNE
Other - Middle Name:
Other - Last Name:PARIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:3601 W COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3300
Mailing Address - Country:US
Mailing Address - Phone:954-703-2931
Mailing Address - Fax:954-585-9207
Practice Address - Street 1:3601 W COMMERCIAL BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3300
Practice Address - Country:US
Practice Address - Phone:954-703-2931
Practice Address - Fax:954-585-9207
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9222048207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology