Healthcare Provider Details

I. General information

NPI: 1801368196
Provider Name (Legal Business Name): LEONOR CARABEO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2018
Last Update Date: 12/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8895 SW 136TH ST
MIAMI FL
33176-5816
US

IV. Provider business mailing address

8895 SW 136TH ST
MIAMI FL
33176-5816
US

V. Phone/Fax

Practice location:
  • Phone: 305-256-5480
  • Fax:
Mailing address:
  • Phone: 305-256-5480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9404986
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: