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Individual

SUZIE JEROME-LEACOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
17611 NW 11TH AVE, MIAMI, FL 33169-4609
(305) 720-0577
Mailing address
17611 NW 11TH AVE, MIAMI, FL 33169-4609
(305) 720-0577

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
9324336
FL
363LA2200X
Adult Health Nurse Practitioner
APRN9324336
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2016009392
ANCC
FL
Enumeration date
11/06/2016
Last updated
10/24/2024
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