Provider Demographics
NPI:1588382188
Name:AWOKANG, LEONEL N (DC)
Entity type:Individual
Prefix:DR
First Name:LEONEL
Middle Name:N
Last Name:AWOKANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10475 GANDY BLVD N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2498
Mailing Address - Country:US
Mailing Address - Phone:781-632-0203
Mailing Address - Fax:
Practice Address - Street 1:7895 SEMINOLE BLVD STE 102
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-4891
Practice Address - Country:US
Practice Address - Phone:727-202-6963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14183111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor