1689025579 NPI number — ZUSELT LEON APRN

Table of content: ZUSELT LEON APRN (NPI 1689025579)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689025579 NPI number — ZUSELT LEON APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEON
Provider First Name:
ZUSELT
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689025579
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5101 SW 8TH STREET
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
CORAL GABLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33134-2442
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-359-5037
Provider Business Mailing Address Fax Number:
786-509-5544

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10305 NW 41ST STREET
Provider Second Line Business Practice Location Address:
SUITE 212
Provider Business Practice Location Address City Name:
DORAL
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33178
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-791-0316
Provider Business Practice Location Address Fax Number:
305-774-5916
Provider Enumeration Date:
06/22/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  APRN9263082 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 114716500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com