Individual
LEANNE S HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
(813) 972-5055
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
(813) 972-5055
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9103592
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292289400
—
FL
01
—
P00733186
RAILROAD MEDICARE
FL
Enumeration date
02/15/2006
Last updated
12/13/2010
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