Doctor Name: | MR. CHARLES RICHARD LEIDNER |
NPI Number: | 1144558180 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | OTR |
License Number: | OT 4918 |
Business Practice Address: | 3141 N Mcmullen Booth Rd Clearwater, FL - 337612035 |
Business Phone Number: | 7277237735 |
Business Fax Number: | 7277267696 |
Mailing Address: | 3141 N Mcmullen Booth Rd, CLEARWATER |
State: | FL |
Postal Code: | 337612035 |
Phone Number: | 7277237735 |
Fax Number: | 7277267696 |
NPI Enumeration Date: | 12/03/2009 |
NPI Last Update Date: | 12/03/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | OT 4918 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |