Individual
STEPHANIE M LEIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
930 LAKE BALDWIN LN, ORLANDO, FL 32814-6651
(407) 898-1500
Mailing address
930 LAKE BALDWIN LN, ORLANDO, FL 32814-6651
(407) 898-1500
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
ME160822
FL
207VG0400X
Gynecology Physician
Primary
ME160822
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117419300
—
FL
Enumeration date
03/22/2016
Last updated
01/04/2024
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