Provider Demographics
NPI:1447859723
Name:WALKER, LESLIE M (DO)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:M
Last Name:WALKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 SW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-7538
Mailing Address - Country:US
Mailing Address - Phone:954-695-3622
Mailing Address - Fax:
Practice Address - Street 1:1801 WEST SAMPLE ROADSUITE 301 & 103
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33064-2510
Practice Address - Country:US
Practice Address - Phone:954-486-4085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-19
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS22630207QH0002X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program