Provider Demographics
NPI:1285114470
Name:LEDEZMA SANABRIA, LEIDY (RN)
Entity type:Individual
Prefix:
First Name:LEIDY
Middle Name:
Last Name:LEDEZMA SANABRIA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6090 W FLAGLER ST # A-306
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-3262
Mailing Address - Country:US
Mailing Address - Phone:305-244-0694
Mailing Address - Fax:305-541-8920
Practice Address - Street 1:2350 SW 8TH ST STE 202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4916
Practice Address - Country:US
Practice Address - Phone:305-541-2333
Practice Address - Fax:305-541-8920
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9451347163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN9451347OtherRN