Individual
LESLIE B VIDAL
Active
Individual
LESLIE B VIDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
43543
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26925729
—
CO
Enumeration date
09/28/2006
Last updated
03/13/2020
Update your record
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