Provider Demographics
NPI:1720761620
Name:DA SILVA, LEONARDO BARRETO PEREIRA (APRN, PHMNP-BC)
Entity Type:Individual
Prefix:
First Name:LEONARDO
Middle Name:BARRETO PEREIRA
Last Name:DA SILVA
Suffix:
Gender:M
Credentials:APRN, PHMNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E OAKLAND PARK BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-4400
Mailing Address - Country:US
Mailing Address - Phone:954-561-6222
Mailing Address - Fax:954-990-7650
Practice Address - Street 1:9685 LAKE NONA VILLAGE PL STE 103
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7321
Practice Address - Country:US
Practice Address - Phone:407-557-8160
Practice Address - Fax:407-557-8159
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11027607363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health