Healthcare Provider Details

I. General information

NPI: 1467342410
Provider Name (Legal Business Name): LEYSHA REYES PLACENCIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. EST. PR 469 KM 0.2 BO. CAIMITAL BAJO
AGUADILLA PR
00603
US

IV. Provider business mailing address

C9 CALLE 1
CAROLINA PR
00982-2032
US

V. Phone/Fax

Practice location:
  • Phone: 787-658-0000
  • Fax:
Mailing address:
  • Phone: 939-257-7399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number25138
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: