MEDICARE: ANA LAURA LEYVA ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	9303383	FL

General Provider Information

NPI Number	:	1235633488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA LAURA LEYVA ARNP

Provider Business Mailing Address
First Line	:	3544 FORT SIMMONS AVE
Second Line	:
City	:	FORT DENAUD
State	:	FL
Zip	:	33935-6309
Country	:	US
Telephone Number	:	239-867-8426
Fax Number	:

Provider Business Practice Location Address
First Line	:	16010 OLD 41 N UNIT 102
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34110
Country	:	US
Telephone Number	:	239-789-2300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2018
Last Update Date	:	07/17/2018

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