Leslie Mobley, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA18408 Issued in FL

Practice address

10820 Marvin E. Jones Blvd.
Live Oak, FL 32060

Phone

(386) 658-5865

Fax

(386) 658-5542

NPI assigned

Nov 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700958691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15510 COUNTY ROAD 250",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320606070",
            "telephone_number": "386-658-5865",
            "fax_number": "386-658-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10820 MARVIN E. JONES BLVD.",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "32060",
            "telephone_number": "386-658-5865",
            "fax_number": "386-658-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBLEY",
        "first_name": "LESLIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA18408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meridian Behavioral Healthcare
• Meridian Behavioral Healthcare, Inc.
• Jennifer Sullivan Merola, APRN
• Lindsey Allen Minshew, APRN
• Rosalie Delaney Mitchell, LM, CPM
• Kochicheril N Moni, M.D.
• Patricia Ann Morgan, RN
• Melanie Alyse Morris, B.S.ED
• Michelle Denise Morris, ARNP
• Julie Mossburg, LMT

• Physical Therapy Assistant in Live Oak, FL
• Providers in Live Oak, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.