# LEIVA MEDICAL APRN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578221057
- **Authorized official:** CARLOS LEIVA (OWNER)
- **Authorized official phone:** (786) 366-1153

## Contact information

- **Practice address:** 10030 SW 40TH ST STE A, MIAMI, FL 33165-3994
- **Practice address phone:** (786) 366-1153
- **Mailing address:** 10030 SW 40TH ST STE A, MIAMI, FL 33165-3994

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/02/2021
- **Last updated:** 12/02/2021