Provider Demographics
NPI:1568856102
Name:LLEVA, OSCAR III (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:OSCAR
Middle Name:
Last Name:LLEVA
Suffix:III
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 HOWELL MILL RD NW APT 705
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-6198
Mailing Address - Country:US
Mailing Address - Phone:310-746-6492
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE ST NE STE 11
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2247
Practice Address - Country:US
Practice Address - Phone:404-686-8802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN298621363LF0000X
NY339413363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily