Individual
CLAUDIA E. VILLALOBOS LEIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2275 FORTUNE RD, KISSIMMEE, FL 34744-4404
(407) 201-5179
Mailing address
615 BLAKE AVE, DAVENPORT, FL 33897-6207
(407) 936-8553
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
377
FL
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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