Individual
EMILY LEECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
640 21ST ST, VERO BEACH, FL 32960-0933
(772) 299-1092
Mailing address
2562 CHEVAL ST APT 107, ORLANDO, FL 32828-7634
(814) 795-9854
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PAX000015159
FL
363AM0700X
Medical Physician Assistant
Primary
PA9111751
FL
Other
Enumeration date
10/23/2018
Last updated
01/21/2019
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