Provider Demographics
NPI:1487699922
Name:RINEHART, LEON O (CRNA)
Entity type:Individual
Prefix:MR
First Name:LEON
Middle Name:O
Last Name:RINEHART
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:LEON
Other - Middle Name:ORVILLE
Other - Last Name:RINEHART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-265-0077
Mailing Address - Fax:352-265-6922
Practice Address - Street 1:1600 SW ARCHER ROAD
Practice Address - Street 2:BOX 100371
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610
Practice Address - Country:US
Practice Address - Phone:352-265-0077
Practice Address - Fax:352-265-6922
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1680092367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3046524000Medicaid
FLG1729TMedicare PIN