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NPI Code Detail

MEDICARE: LUZ REINA LEDESMA APRN,PMHNP-BC

MEDICARE: LUZ REINA LEDESMA APRN,PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner11032278FL

General Provider Information

NPI Number : 1689428526
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUZ REINA LEDESMA APRN,PMHNP-BC
Provider Business Mailing Address
First Line : PO BOX 961237
Second Line :
City : MIAMI
State : FL
Zip : 33296-1237
Country : US
Telephone Number : 305-763-0148
Fax Number :
Provider Business Practice Location Address
First Line : 10226 CURRY FORD RD
Second Line :
City : ORLANDO
State : FL
Zip : 32825-8735
Country : US
Telephone Number : 786-707-7135
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2024
Last Update Date : 03/16/2026

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