Provider Demographics
NPI:1427431741
Name:LEIVA SOLIS, DANIA IVELISSE (MD)
Entity type:Individual
Prefix:DR
First Name:DANIA
Middle Name:IVELISSE
Last Name:LEIVA SOLIS
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:PO BOX 7114
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-7114
Mailing Address - Country:US
Mailing Address - Phone:787-653-0550
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL MENONITA CAGUAS
Practice Address - Street 2:CARR 172
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-653-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-06
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19719207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine