Individual
CARLOS ENRIQUE LEIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
206 SW 76TH AVE, MIAMI, FL 33144-2426
(786) 366-1153
Mailing address
206 SW 76TH AVE, MIAMI, FL 33144-2426
(786) 366-1153
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11003521
FL
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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