Active NPI
Leiddy K Ramirez Avila
- Medical Physician Assistant
- Miramar, FL
National Provider Identifier
1013633205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 1484
- Practice address
- 2812 Island Dr
Miramar, FL 33023-5809 - Phone
- (786) 290-1496
- NPI assigned
- Oct 18, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10431 | AZ | |
| Medical Physician Assistant | 363AM0700X | TPPA379 | FL | |
| Medical Physician Assistant | 363AM0700X | 1484 | PR | Primary |
Addresses
Primary practice location
2812 Island Dr
Miramar, FL 33023-5809
Mailing address
2812 Island Dr
Miramar, FL 33023-5809
Phone (786) 290-1496
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10431 | AZ | MD | Physician Assistant |
| TPPA379 | FL | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726012800000",
"number": "1013633205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2812 ISLAND DR",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330235809",
"telephone_number": "786-290-1496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2812 ISLAND DR",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330235809",
"telephone_number": "786-290-1496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAMIREZ AVILA",
"first_name": "LEIDDY",
"middle_name": "K",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-18",
"last_updated": "2024-09-11",
"certification_date": "2024-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "10431",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "TPPA379",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PR",
"license": "1484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.