Provider Demographics
NPI:1396731543
Name:LEONARD, TRACY E (RPH)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:E
Last Name:LEONARD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 NW 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4080
Mailing Address - Country:US
Mailing Address - Phone:352-371-0891
Mailing Address - Fax:352-622-3318
Practice Address - Street 1:1730 SW 1ST AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-5170
Practice Address - Country:US
Practice Address - Phone:352-690-6760
Practice Address - Fax:352-622-3318
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS26878183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist