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General NPI Number Information
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NPI Number | 1093639262
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Entity Type | Organization
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Legal Business Name | RETROMODERNO PRIMARY CARE CORP
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Dates
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Enumeration Date | 08/08/2026
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Last Update Date | 08/08/2026
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Provider Practice Location Address
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Address Line | 8040 NW 95TH ST STE 109
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-2360
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Country | US
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Telephone | 786-414-0990
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Fax | 786-558-5896
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Provider Business Mailing Address
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Address Line | 8040 NW 95TH ST STE 109
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-2360
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Country | US
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Telephone | 786-414-0990
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Fax | 786-558-5896
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Authorized Official
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Title or Position | OWNER
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Name | YULIET VARONA LEYVA
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Credential | APRN, FNP-C
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Telephone | 786-414-0990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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