Provider Demographics
NPI:1699898023
Name:LEONARD, BEVERLY YVONNE (RN)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:YVONNE
Last Name:LEONARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 E SILVER SPRINGS BLVD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-6831
Mailing Address - Country:US
Mailing Address - Phone:352-369-2100
Mailing Address - Fax:
Practice Address - Street 1:1515 E SILVER SPRINGS BLVD
Practice Address - Street 2:SUITE 213
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6831
Practice Address - Country:US
Practice Address - Phone:352-369-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9249859163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL312182800Medicaid