Provider Demographics
NPI:1235633488
Name:LEYVA, ANA LAURA (ARNP)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:LAURA
Last Name:LEYVA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3544 FORT SIMMONS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT DENAUD
Mailing Address - State:FL
Mailing Address - Zip Code:33935-6309
Mailing Address - Country:US
Mailing Address - Phone:239-867-8426
Mailing Address - Fax:
Practice Address - Street 1:16010 OLD 41 N UNIT 102
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110
Practice Address - Country:US
Practice Address - Phone:239-789-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9303383363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily