Individual provider Active NPI

John Dallas Leeah

  • Medical Technologist
  • Tampa, FL
National Provider Identifier
1144451857
Registry record updated Jul 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical TechnologistTaxonomy code 246QM0706X
License
B1401639 Issued in FL
Practice address
8415 Bayshore Blvd
Tampa, FL 33621-1607
Phone
(813) 827-9805
NPI assigned
Jul 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Technologist 246QM0706X B1401639 FL Primary

Addresses

Primary practice location

8415 Bayshore Blvd
Tampa, FL 33621-1607

Mailing address

6306 S Macdill Ave Apt 1003
Tampa, FL 33611-5078
Phone (813) 244-0837

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
B1401639FLMDMedical Technologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248825600000",
    "number": "1144451857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6306 S MACDILL AVE APT 1003",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336115078",
            "telephone_number": "813-244-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 BAYSHORE BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336211607",
            "telephone_number": "813-827-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEEAH",
        "first_name": "JOHN",
        "middle_name": "DALLAS",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-29",
        "last_updated": "2009-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": "FL",
            "license": "B1401639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.