Individual
DR. LESLIE ANN JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
2919 W SWANN AVE, SUITE 203, TAMPA, FL 33609-4038
(813) 875-0555
(866) 313-3106
Mailing address
2919 W SWANN AVE, SUITE 203, TAMPA, FL 33609-4038
(813) 875-0555
(866) 313-3106
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO 3548
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
PO 3548
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6501W
BCBS
FL
01
—
DA5546
RR MCARE GROUP
FL
01
—
K5276
MCARE GROUP PTAN
FL
01
—
P01125212
RR MCARE IND
FL
01
—
PO3548
MEDICAL LICENSE
FL
Enumeration date
06/29/2009
Last updated
10/24/2013
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