Healthcare Provider Details

I. General information

NPI: 1164098257
Provider Name (Legal Business Name): LEILY SANTOS-CARRION
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2021
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ALTON RD
MIAMI BEACH FL
33140-2948
US

IV. Provider business mailing address

4310 ALTON RD
MIAMI BEACH FL
33140
US

V. Phone/Fax

Practice location:
  • Phone: 786-546-4615
  • Fax:
Mailing address:
  • Phone: 305-535-3310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF05210780
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberRN9433181
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: