Provider Demographics
NPI:1437747714
Name:CARLOS A LEYVA JORDAN LLC
Entity Type:Organization
Organization Name:CARLOS A LEYVA JORDAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC ENDOCRINOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:LEYVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-679-3161
Mailing Address - Street 1:1845 CARR 2
Mailing Address - Street 2:SUITE 213 BAYAMON MEDICAL PLAZA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-622-8451
Mailing Address - Fax:787-622-8453
Practice Address - Street 1:1845 CARR 2
Practice Address - Street 2:SUITE 213 BAYAMON MEDICAL PLAZA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-622-8451
Practice Address - Fax:787-622-8453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric EndocrinologyGroup - Single Specialty