Provider Demographics
NPI:1841871019
Name:LEYVA REYES, LIRIAN DEL CARMEN (MD)
Entity type:Individual
Prefix:
First Name:LIRIAN
Middle Name:DEL CARMEN
Last Name:LEYVA REYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 NE 125TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4717
Mailing Address - Country:US
Mailing Address - Phone:305-570-0012
Mailing Address - Fax:786-522-9352
Practice Address - Street 1:428 NE 125TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-4717
Practice Address - Country:US
Practice Address - Phone:305-570-0012
Practice Address - Fax:786-522-9352
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1476208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice