Individual
DEIRDRE LEAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1750 TREE BLVD, SUITE 10, ST AUGUSTINE, FL 32084-5715
(904) 810-5434
(904) 810-5282
Mailing address
15280 NW 79TH CT STE 200, MIAMI LAKES, FL 33016-5873
(305) 558-3724
(786) 907-4485
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
ME91018
FL
207YS0123X
Facial Plastic Surgery Physician
Primary
ME91018
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00255496
RAILROAD MEDICARE
FL
Enumeration date
09/13/2006
Last updated
06/12/2025
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