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General NPI Number Information
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NPI Number | 1942889803
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Entity Type | Individual
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Provider Name | YOEL TAJES LEIVA MD
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Gender | Male
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Dates
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Enumeration Date | 04/06/2021
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 909 N MIAMI BEACH BLVD STE 203
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-3712
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Country | US
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Telephone | 305-786-5370
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Fax | 305-786-5371
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Provider Business Mailing Address
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Address Line | 12401 W OKEECHOBEE RD LOT 484
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-2942
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Country | US
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Telephone | 305-786-5370
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Fax | 305-786-5371
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 59577
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME164504
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License Number State | FL
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