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General NPI Number Information
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NPI Number | 1588849335
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Entity Type | Individual
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Provider Name | AURORA LEYVA RICHTER MD
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Gender | Female
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Dates
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Enumeration Date | 12/28/2007
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Last Update Date | 04/05/2018
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Provider Practice Location Address
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Address Line | 9857 OLD SAINT AUGUSTINE RD STE 4
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City | JACKSONVILLE
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State | FL
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Zip | 32257-8821
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Country | US
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Telephone | 904-861-1900
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Fax | 904-292-9264
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Provider Business Mailing Address
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Address Line | 9857 OLD SAINT AUGUSTINE RD STE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32257-8821
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Country | US
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Telephone | 904-260-4461
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Fax | 904-292-9684
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME100592
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License Number State | FL
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