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Individual

DR. LESLIE F CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 767-4243
(727) 767-8612
Mailing address
501 6TH AVE S, BOX 6941, ST PETERSBURG, FL 33701-4634
(727) 767-4429
(727) 767-4970

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD041783L
PA
208000000X
Pediatrics Physician
Primary
ME98106
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000113100
FL
05
001210693
PA
01
323324
AVMED
01
4254661
AETNA
01
471557
STAYWELL/HEALTHEASE
01
91022
BC/BS
FL
01
9217007
CIGNA
Enumeration date
09/27/2005
Last updated
10/19/2010
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