Provider Demographics
NPI:1558139188
Name:RODRIGUEZ TORNES, LEODANIS (FNP)
Entity Type:Individual
Prefix:
First Name:LEODANIS
Middle Name:
Last Name:RODRIGUEZ TORNES
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11701 NW 31ST ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-1201
Mailing Address - Country:US
Mailing Address - Phone:786-399-1955
Mailing Address - Fax:
Practice Address - Street 1:11701 NW 31ST ST
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-1201
Practice Address - Country:US
Practice Address - Phone:786-399-1955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11030104363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily