Provider Demographics
NPI:1982097390
Name:LEONARD, SHERLYN
Entity type:Individual
Prefix:
First Name:SHERLYN
Middle Name:
Last Name:LEONARD
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 1:1236 N PINE HILLS RD
Mailing Address - Street 2:STE B
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-6231
Mailing Address - Country:US
Mailing Address - Phone:407-295-8683
Mailing Address - Fax:800-572-3749
Practice Address - Street 1:1236 N PINE HILLS RD
Practice Address - Street 2:STE B
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-6231
Practice Address - Country:US
Practice Address - Phone:407-295-8683
Practice Address - Fax:407-295-1270
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2023-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP108349172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker