Individual
GISELA GARCIA-LEYVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
211 4TH AVE N, ST PETERSBURG, FL 33701-2911
(727) 823-8366
Mailing address
211 4TH AVE N, ST PETERSBURG, FL 33701-2911
(727) 823-8366
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME0036410
FL
208D00000X
General Practice Physician
ME0036410
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065718200
—
FL
01
—
40649
BLUE CROSS BLUE SHIELD
FL
01
—
593034992
TRICARE
FL
Enumeration date
04/27/2006
Last updated
04/22/2011
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