MEDICARE: LEANNA GREENIDGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1275483968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEANNA GREENIDGE

Provider Business Mailing Address
First Line	:	471 NE 210TH CIRCLE TER APT 201
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-1847
Country	:	US
Telephone Number	:	305-766-8245
Fax Number	:

Provider Business Practice Location Address
First Line	:	471 NE 210TH CIRCLE TER APT 201
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-1847
Country	:	US
Telephone Number	:	305-766-8245
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/05/2026

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Directions to “ LEANNA GREENIDGE ” Practice Location

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