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General NPI Number Information
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NPI Number | 1831779479
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Entity Type | Individual
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Provider Name | MILADYS LISTE LEON
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Gender | Female
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 20 E MELBOURNE AVE STE 101
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City | MELBOURNE
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State | FL
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Zip | 32901-5970
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Country | US
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Telephone | 321-312-1167
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Fax | 321-312-1201
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Provider Business Mailing Address
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Address Line | 601 S HARBOUR ISLAND BLVD STE 200
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City | TAMPA
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State | FL
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Zip | 33602-5925
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Country | US
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Telephone | 727-322-3439
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Fax | 800-928-7449
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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 | 11012227
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License Number State | FL
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