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Organization

LEONIE KING LLC

Active
Other names
Ponte Vedra Premier Healthcare
Organization subpart
No

Provider details

NPI number
Authorized official
LEONIE CICELY KING NP (CEO)
(757) 842-0062
Entity
Organization

Contact information

Practice address
90 FORT WADE RD, PONTE VEDRA BEACH, FL 32081-5146
(757) 842-0062
Mailing address
7643 GATE PKWY STE 104, JACKSONVILLE, FL 32256-2893
(757) 842-0062

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary

Other

Enumeration date
04/11/2026
Last updated
04/11/2026
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