Individual
BETH ANN M LEAF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1942 HIGHLAND OAKS BLVD, SUITE A, LUTZ, FL 33559-7410
(813) 948-3838
(813) 949-0629
Mailing address
1834 FIRCREST CT, WESLEY CHAPEL, FL 33543-8168
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103104
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292838800
—
FL
01
—
P00625639
RR MEDICARE
FL
Enumeration date
08/15/2006
Last updated
04/04/2023
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