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Individual

LESLEY ELLEN BRINKMAN-MOSIMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M. D.

Contact information

Practice address
4030 W BOY SCOUT BLVD STE 800, TAMPA, FL 33607-5713
(813) 286-0333
(813) 282-1806
Mailing address
PO BOX 748817, ATLANTA, GA 30374-8817
(813) 286-0333
(813) 282-1806

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036-076129
IL
207V00000X
Obstetrics & Gynecology Physician
Primary
ME141553
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036076129
IL
01
9032006
BLUE CROSS BLUE SHIELD
IL
01
LM689
MEDICARE
FL
Enumeration date
11/09/2006
Last updated
06/22/2023
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