Doctor Name: | LESLEE E BAUTE |
NPI Number: | 1164672721 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | PAT9104766 |
Business Practice Address: | 4002 Sun City Center Blvd Unit 102 Sun City Center, FL - 335735208 |
Business Phone Number: | 8136341455 |
Business Fax Number: | 8136428355 |
Mailing Address: | 4002 Sun City Center Blvd, Unit 102 SUN CITY CENTER |
State: | FL |
Postal Code: | 335735208 |
Phone Number: | 8136341455 |
Fax Number: | 8136428355 |
NPI Enumeration Date: | 09/19/2008 |
NPI Last Update Date: | 08/04/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | PAT9104766 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |