Individual
LEAH ANNE DE LA CUADRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
78 MEDIO DR, ST AUGUSTINE, FL 32095-6719
(201) 230-9850
Mailing address
78 MEDIO DR, ST AUGUSTINE, FL 32095-6719
(201) 230-9850
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
RN9368881
FL
163WH0200X
Home Health Registered Nurse
RN9368881
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN9368881
DOH
FL
Enumeration date
10/25/2017
Last updated
10/25/2017
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