Deirdre Leake, MD
Facial Plastic Surgery Physician · St Augustine, FL
Practice location
1750 Tree BlvdSuite 10
St Augustine, FL 32084-5715
- Phone
- (904) 810-5434
- Fax
- (904) 810-5282
NPI record
- NPI
- 1073617585
- Entity type
- Individual (Type 1)
- Enumeration date
- September 13, 2006
- Last updated
- June 12, 2025
- Certified
- June 12, 2025
- Sole proprietor
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Facial Plastic Surgery Physician Primary | 207YS0123X |
ME91018 | FL |
| Otolaryngology Physician | 207Y00000X |
ME91018 | FL |
Mailing address
15280 NW 79TH Ct Ste 200Miami Lakes, FL 33016-5873
- Phone
- (305) 558-3724
- Fax
- (786) 907-4485
About Dr. Leake
Deirdre Leake, MD is a healthcare provider registered in the NPI registry with the primary taxonomy Facial Plastic Surgery Physician (code 207YS0123X). The practice location is 1750 Tree Blvd, Suite 10, St Augustine, FL 32084-5715. The NPI number 1073617585 was assigned on September 13, 2006 and the record was last updated on June 12, 2025.
Dr. Leake lists 2 licenses in the registry: #ME91018 (FL) for Facial Plastic Surgery Physician; #ME91018 (FL) for Otolaryngology Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Deirdre Leake, MD?
The NPI number is 1073617585.
What is the phone number of Dr. Leake?
The phone number listed for the practice location is (904) 810-5434.
Where is Dr. Leake located?
1750 Tree Blvd, Suite 10, St Augustine, FL 32084-5715.
What is the taxonomy code for Dr. Leake?
The primary taxonomy code is 207YS0123X – Facial Plastic Surgery Physician; 1 more listed above.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.