Healthcare Provider Details

I. General information

NPI: 1881569085
Provider Name (Legal Business Name): SANDRA CARRION DE LEON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3261 U. S. HIGHWAY 441 BUILDING E-2
FRUITLAND PARK FL
34731
US

IV. Provider business mailing address

3261 U. S. HIGHWAY 441 BUILDING E-2
FRUITLAND PARK FL
34731
US

V. Phone/Fax

Practice location:
  • Phone: 352-615-0926
  • Fax:
Mailing address:
  • Phone: 352-615-0926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299996560
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: