Provider Demographics
NPI:1962220574
Name:LEDFORD, ZOEY
Entity type:Individual
Prefix:
First Name:ZOEY
Middle Name:
Last Name:LEDFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6212 FALLINGLEAF CT N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-2050
Mailing Address - Country:US
Mailing Address - Phone:727-776-8463
Mailing Address - Fax:
Practice Address - Street 1:6212 FALLINGLEAF CT N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-2050
Practice Address - Country:US
Practice Address - Phone:727-776-8463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035603363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily