MEDICARE: LEILA ESME JOHNSON MT-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
1	225A00000X	Music Therapist	18440	FL
2	171W00000X	Contractor	18440	FL

General Provider Information

NPI Number	:	1861227381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEILA ESME JOHNSON MT-BC

Provider Business Mailing Address
First Line	:	18301 S DIXIE HWY APT 336
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-5556
Country	:	US
Telephone Number	:	646-771-1699
Fax Number	:

Provider Business Practice Location Address
First Line	:	5701 SUNSET DR STE 282
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5369
Country	:	US
Telephone Number	:	305-763-8132
Fax Number	:

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

Provider Enumeration Date	:	09/04/2024
Last Update Date	:	10/15/2025

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Directions to “ LEILA ESME JOHNSON MT-BC” Practice Location

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