Individual
JENNIFER P LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8931 COLONIAL CENTER DR STE 400, FORT MYERS, FL 33905-7809
(239) 319-3714
(239) 343-9977
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9960
(239) 343-9977
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106333
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004281100
—
FL
Enumeration date
10/07/2011
Last updated
12/30/2025
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