Provider Demographics
NPI:1144327586
Name:SENORS, LEIDEE KARENNA (MD)
Entity type:Individual
Prefix:DR
First Name:LEIDEE
Middle Name:KARENNA
Last Name:SENORS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:L. KARENNA
Other - Middle Name:
Other - Last Name:SENORS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4930 E LAKE MARY BLVD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-5003
Mailing Address - Country:US
Mailing Address - Phone:407-322-8645
Mailing Address - Fax:407-956-4334
Practice Address - Street 1:4930 E LAKE MARY BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-5003
Practice Address - Country:US
Practice Address - Phone:407-322-8645
Practice Address - Fax:407-956-4334
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92973207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274627100Medicaid
FL274627100Medicaid
FL378406OtherWELLCARE
FL01134857OtherAMERIGROUP
FL01134857OtherAMERIGROUP
FL46051OtherBC/BS