Provider Demographics
NPI:1285219642
Name:ZAYAS-BAZAN, LEONARDO (DPM)
Entity Type:Individual
Prefix:
First Name:LEONARDO
Middle Name:
Last Name:ZAYAS-BAZAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9035 SUNSET DR STE 200B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3451
Mailing Address - Country:US
Mailing Address - Phone:305-564-3810
Mailing Address - Fax:305-686-9884
Practice Address - Street 1:8440 S DIXIE HWY APT 1404
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-7825
Practice Address - Country:US
Practice Address - Phone:305-510-2829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4269213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery