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General NPI Number Information
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NPI Number | 1265145932
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Entity Type | Individual
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Provider Name | KENYA LEYVA APRN
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Gender | Female
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Dates
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Enumeration Date | 12/27/2022
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 2624 ATLANTIC BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32207-3609
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Country | US
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Telephone | 904-513-3240
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Fax | 904-398-7871
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Provider Business Mailing Address
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Address Line | 13990 BARTRAM PARK BLVD UNIT 2107
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5573
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Country | US
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Telephone | 786-302-9296
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11023704
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License Number State | FL
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