Provider Demographics
NPI:1992569685
Name:MOREIRA HERNANDEZ, LEONID L (APRN)
Entity type:Individual
Prefix:
First Name:LEONID
Middle Name:L
Last Name:MOREIRA HERNANDEZ
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 W OAK ST STE 103
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4973
Mailing Address - Country:US
Mailing Address - Phone:407-931-0444
Mailing Address - Fax:407-962-4446
Practice Address - Street 1:2685 SW 32ND PL STE 100
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-7863
Practice Address - Country:US
Practice Address - Phone:407-931-0444
Practice Address - Fax:407-962-4446
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11031145363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily