Saint Leo University

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

RN9202490 Issued in FL

Legal business name

SAINT LEO UNIVERSITY

Practice address

33701 St. Rd. 52. Ste Mc2246
Saint Leo, FL 33574

Phone

(352) 588-8347

Fax

(352) 588-8305

NPI assigned

Jan 6, 2009

Organization subpart

Yes

Parent organization

SAINT LEO UNIVERSITYAs reported in NPPES

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

Authorized official

Name

Teresa Grace Dodez, R.N.

Title

Director of Health & Wellness Cente

Phone

(352) 588-8347

Specialties & licenses 2

Addresses

Part of

Saint Leo University

Locations

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

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1255577656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33701 ST. RD. 52 STE MC2246",
            "city": "SAINT LEO",
            "state": "FL",
            "postal_code": "33574",
            "telephone_number": "352-588-8347",
            "fax_number": "352-588-8305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33701 ST. RD. 52. STE MC2246",
            "city": "SAINT LEO",
            "state": "FL",
            "postal_code": "33574",
            "telephone_number": "352-588-8347",
            "fax_number": "352-588-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT LEO UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAINT LEO UNIVERSITY",
        "enumeration_date": "2009-01-06",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "DODEZ",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "DIRECTOR OF HEALTH & WELLNESS CENTE",
        "authorized_official_telephone_number": "352-588-8347",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "ME81580",
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "RN9202490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Jimenez-Manley, LMHC
• Steven Jurnak Jr.
• Kevin M. Kieffer, PH.D.
• Khalilah Louis Caines, PH.D., LCSW
• Kevin Rojas
• Thomas Spock III, ATC
• Varsity Health LLC
• Barbara Booth Wilson, ATC, LIC

• Health Service Clinic/Center in Saint Leo, FL
• Providers in Saint Leo, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.