Provider Demographics
NPI:1669417366
Name:LEYVA, LUIS PABLO JR (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:PABLO
Last Name:LEYVA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9595 N KENDALL DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1979
Mailing Address - Country:US
Mailing Address - Phone:305-279-8222
Mailing Address - Fax:305-279-4096
Practice Address - Street 1:9595 N KENDALL DR
Practice Address - Street 2:SUITE 103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1979
Practice Address - Country:US
Practice Address - Phone:305-279-8222
Practice Address - Fax:305-279-4096
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
FLME56849207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF51637Medicare UPIN
FLK5219Medicare ID - Type Unspecified