Healthcare Provider Details

I. General information

NPI: 1215833892
Provider Name (Legal Business Name): LEIDI FERNANDEZ X
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2026
Last Update Date: 10/19/2026
Certification Date: 10/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7225 W 11TH CT APT 226
HIALEAH FL
33014-4646
US

IV. Provider business mailing address

7225 W 11TH CT APT 226
HIALEAH FL
33014-4646
US

V. Phone/Fax

Practice location:
  • Phone: 786-488-4357
  • Fax:
Mailing address:
  • Phone: 786-488-4357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11050372
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: