Provider Demographics
NPI:1962294744
Name:CARLSON, LEONARD DAVID (ARNP)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:DAVID
Last Name:CARLSON
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 BARCARMIL WAY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-0903
Mailing Address - Country:US
Mailing Address - Phone:239-265-3391
Mailing Address - Fax:239-310-2035
Practice Address - Street 1:936 BARCARMIL WAY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-0903
Practice Address - Country:US
Practice Address - Phone:239-265-3391
Practice Address - Fax:239-310-2035
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11039321363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health