Provider Demographics
NPI:1013035518
Name:ORLANDO E. LEIVA, M.D., P.A.
Entity Type:Organization
Organization Name:ORLANDO E. LEIVA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEIVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-323-1812
Mailing Address - Street 1:P.O. BOX 522483
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33152-2483
Mailing Address - Country:US
Mailing Address - Phone:305-323-1812
Mailing Address - Fax:305-229-2844
Practice Address - Street 1:14990 SW 43RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-4381
Practice Address - Country:US
Practice Address - Phone:305-323-1812
Practice Address - Fax:305-229-2844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN 366208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty