Provider Demographics
NPI:1619491859
Name:ENGELMANN, LEONILA ABAN (APRN)
Entity Type:Individual
Prefix:
First Name:LEONILA
Middle Name:ABAN
Last Name:ENGELMANN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4780 SW 64TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-4400
Mailing Address - Country:US
Mailing Address - Phone:954-434-1705
Mailing Address - Fax:954-434-1882
Practice Address - Street 1:4780 SW 64TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-4400
Practice Address - Country:US
Practice Address - Phone:954-434-1705
Practice Address - Fax:954-434-1882
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9326956363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty