Individual
LEO CHRISTOPHER DEROSIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2030 FLEISCHMANN RD, TALLAHASSEE, FL 32308
(850) 219-2000
(850) 877-2138
Mailing address
2030 FLEISCHMANN RD, TALLAHASSEE, FL 32308
(850) 219-2000
(850) 877-2138
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME116517
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051116208
BCBS
AL
01
—
051116209
BCBS
AL
01
—
051116211
BCBS
AL
01
—
051116212
BCBS
AL
01
—
051116213
BCBS
AL
05
—
05683733
—
MS
05
—
128741
—
AL
05
—
128744
—
AL
05
—
128750
—
AL
05
—
128756
—
AL
05
—
128758
—
AL
Enumeration date
05/11/2007
Last updated
08/04/2015
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