Provider Demographics
NPI:1790959294
Name:THORSON, WILLA LEANAH (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLA
Middle Name:LEANAH
Last Name:THORSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:WILLA
Other - Middle Name:LEANAH
Other - Last Name:CROSBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1501 NW 10TH AVENUE
Mailing Address - Street 2:BIOMEDICAL RESEARCH BUILDING ROOM 369
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136
Mailing Address - Country:US
Mailing Address - Phone:305-213-2823
Mailing Address - Fax:305-243-3919
Practice Address - Street 1:1501 NW 10TH AVE BLDG ROOM369
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1012
Practice Address - Country:US
Practice Address - Phone:305-213-2823
Practice Address - Fax:305-243-3919
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA137741207R00000X, 208000000X
FLME113650207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics