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Individual
LESLIE T POWELL
Active
Individual
LESLIE T POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9116235
FL
363AM0700X
Medical Physician Assistant
0110001777
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053458976
—
VA
05
—
120707600
—
FL
Enumeration date
01/31/2007
Last updated
02/07/2024
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