Individual
LESLIE SUZANN HORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2700 RIVERSIDE AVE STE 2, JACKSONVILLE, FL 32205-8233
(904) 265-7020
(904) 621-0566
Mailing address
705 WELLS RD STE 300, ORANGE PARK, FL 32073-2982
(904) 282-6331
(904) 619-1080
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9103683
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9103683
FLORIDA LICENSE
FL
Enumeration date
10/30/2006
Last updated
08/30/2022
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