Provider Demographics
NPI:1265142772
Name:LEON, ANA GABRIELA (APRN)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:GABRIELA
Last Name:LEON
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 1:17300 NW 68TH AVE APT 316
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4013
Mailing Address - Country:US
Mailing Address - Phone:305-927-4198
Mailing Address - Fax:
Practice Address - Street 1:17300 NW 68TH AVE APT 316
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4013
Practice Address - Country:US
Practice Address - Phone:305-927-4198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-25
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022783164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse