MEDICARE: ELISANGELA SANTOS CORREA LEITE

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	363LP2300X	Primary Care Nurse Practitioner	11042855	FL

General Provider Information

NPI Number	:	1558237214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISANGELA SANTOS CORREA LEITE

Provider Business Mailing Address
First Line	:	1914 LAKE ALDEN DR
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32712-3104
Country	:	US
Telephone Number	:	407-406-2311
Fax Number	:

Provider Business Practice Location Address
First Line	:	8956 TURKEY LAKE RD STE B950
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7327
Country	:	US
Telephone Number	:	407-530-8744
Fax Number	:	407-210-5616

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

Provider Enumeration Date	:	10/10/2025
Last Update Date	:	10/10/2025

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