Healthcare Provider Details

I. General information

NPI: 1568892552
Provider Name (Legal Business Name): LEONARDO TROBAJO LOBAYNA A.R.N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2013
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17241 SW 143RD CT
MIAMI FL
33177-2752
US

IV. Provider business mailing address

730 NW 107TH AVE STE 110
MIAMI FL
33172-3104
US

V. Phone/Fax

Practice location:
  • Phone: 786-448-8187
  • Fax:
Mailing address:
  • Phone: 786-636-1402
  • Fax: 786-636-1403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN9314833
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9314833
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN9314833
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: