Basic Information
| Provider Information | |||||||||
| NPI: | 1013385830 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAO | ||||||||
| FirstName: | LEO | ||||||||
| MiddleName: | LIN | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10051 5TH ST N | ||||||||
| Address2: | STE 200 | ||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337022211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278240780 | ||||||||
| FaxNumber: | 8135148891 | ||||||||
| Practice Location | |||||||||
| Address1: | 9114 TOWN CENTER PKWY STE 102 | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD RANCH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342025054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9412243786 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/10/2015 | ||||||||
| LastUpdateDate: | 01/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD186188 | OR | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | ME134113 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.