Most Relevant Information
Provider Data
| NPI Number: | 1003460999 |
| Provider Name: | CARLOS ENRIQUE LEIVA |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 11003521 |
Most Important Dates
| Enumeration Date: | 07/29/2019 |
| Last Updated: | 07/29/2019 |
Provider Practice Location
206 SW 76TH AVE
MIAMI
FL
331442426
Practice Location Phone/Fax
| Phone: | 7863661153 |
| Fax: |
Provider Mailing Location
206 SW 76TH AVE
MIAMI
FL
331442426
Provider Mailing Phone/Fax
| Phone: | 7863661153 |
| Fax: |