Leake, Deirdre

Leake, Deirdre is an individual health care provider with primary practice located at 1750 Tree Blvd Suite 10, St Augustine FL 32084-5715. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Facial Plastic Surgery. Allopathic & Osteopathic Physicians / Facial Plastic Surgery is her primary health care specialty. Leake, Deirdre can be contacted via phone (904) 810-5434.

Contact Information

Primary practice address
1750 Tree Blvd Suite 10 St Augustine FL 32084-5715
Phone: (904) 810-5434
Fax: (904) 810-5282
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X ME91018 Florida
Allopathic & Osteopathic Physicians / Facial Plastic Surgery 207YS0123X ME91018 Florida

Profile Details

NPI number 1073617585
LBN Legal business name Leake, Deirdre
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2006
Last updated Oct 9th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073617585 NPPES
Florida Other P00255496 RAILROAD MEDICARE

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