Provider Demographics
NPI:1235918483
Name:MOREIRA LEANDRO, JHESYKA
Entity Type:Individual
Prefix:
First Name:JHESYKA
Middle Name:
Last Name:MOREIRA LEANDRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 E MICHIGAN ST APT 2106
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-1645
Mailing Address - Country:US
Mailing Address - Phone:305-609-2428
Mailing Address - Fax:
Practice Address - Street 1:765 W STATE ROAD 434
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4936
Practice Address - Country:US
Practice Address - Phone:407-831-6801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL40587225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist