Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | ME112531 | FL |
N | 208000000X | Pediatrician | MD037831 | DC |
Y | 2080P0201X | Pediatric Allergist | ME112531 | FL |
NPI | 1053590273 |
---|---|
Provider Name | Dr. Jennifer Woodard Leiding |
First Address | Orlando, FL 32806-1141 |
Second Address | Orlando, FL 32806-1141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2007 |
Last Update Date | 18/10/2021 |