Individual
LEIGH ANN MEDARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10000 BAY PINES BLVD, BUILDING 22, ROOM 355, BAY PINES, FL 33744
(727) 398-6111
Mailing address
487 30TH AVE N, ST PETERSBURG, FL 33704-2118
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
172885
NC
207RI0200X
Infectious Disease Physician
Primary
2016-00280
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487945333
—
NC
05
—
NC2868
—
SC
Enumeration date
04/27/2011
Last updated
10/02/2023
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