Provider Demographics
NPI:1528608130
Name:EINSTEIN, LEONARD (APRN, NP-C)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:EINSTEIN
Suffix:
Gender:M
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6445 W 24TH AVE APT 14
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-3982
Mailing Address - Country:US
Mailing Address - Phone:954-655-6559
Mailing Address - Fax:
Practice Address - Street 1:6267 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4845
Practice Address - Country:US
Practice Address - Phone:954-655-6559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-11
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11005762363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily