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General NPI Number Information
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NPI Number | 1477045011
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Entity Type | Individual
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Provider Name | IDANIA LEON MSN,ARNP,FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/30/2018
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 16201 SW 95TH AVE
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City | MIAMI
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State | FL
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Zip | 33157-3459
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Country | US
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Telephone | 305-570-2340
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Fax |
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Provider Business Mailing Address
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Address Line | 14100 SW 152ND PL
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City | MIAMI
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State | FL
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Zip | 33196-5012
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Country | US
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Telephone | 786-201-5271
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9334615
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License Number State | FL
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