Provider Demographics
NPI:1376902270
Name:LEY, PAOLA C
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:C
Last Name:LEY
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 1:3150 PONCE DE LEON BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6826
Mailing Address - Country:US
Mailing Address - Phone:305-305-3321
Mailing Address - Fax:786-504-9432
Practice Address - Street 1:1065 NE 125TH STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161
Practice Address - Country:US
Practice Address - Phone:786-221-0908
Practice Address - Fax:786-235-6225
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-19
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL246YR1600X, 171W00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No246YR1600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationRegistered Record Administrator
No174400000XOther Service ProvidersSpecialist