Provider Demographics
NPI:1851730030
Name:JUARBE RIVERA, LESLIE ANNE (MD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANNE
Last Name:JUARBE RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LESLIE ANNE
Other - Middle Name:
Other - Last Name:JUARBE RIVERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4685 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3397
Mailing Address - Country:US
Mailing Address - Phone:513-853-4721
Mailing Address - Fax:513-852-8525
Practice Address - Street 1:10500 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242
Practice Address - Country:US
Practice Address - Phone:513-865-2246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA309085207P00000X, 207RC0200X
MDD84581207P00000X, 207RC0200X
FLME137204207P00000X, 2086S0102X
OH35.130828207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care