Provider Demographics
NPI:1588737282
Name:LEONARD, JULIE E (PT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:E
Last Name:LEONARD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:15760 MARCELLO CIR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-2841
Mailing Address - Country:US
Mailing Address - Phone:239-398-4607
Mailing Address - Fax:239-352-8610
Practice Address - Street 1:5263 GOLDEN GATE PKWY
Practice Address - Street 2:UNITE E
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-7601
Practice Address - Country:US
Practice Address - Phone:239-352-9884
Practice Address - Fax:239-352-8610
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21086225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty