Active NPI
Irene C Leon
- Pharmacist
- Hialeah, FL
National Provider Identifier
1063081818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19688
- Practice address
- 874 E 41St St
Hialeah, FL 33013-2455 - Phone
- (305) 693-0441
- NPI assigned
- Jun 24, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Pharmacist | 1835G0303X | 19668 | FL | |
| Pharmacist | 183500000X | 19688 | FL | Primary |
Addresses
Primary practice location
874 E 41St St
Hialeah, FL 33013-2455
Mailing address
1437 Lantana Dr
Weston, FL 33326-3601
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659465342 | Medicaid | FL |
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 |
|---|---|---|---|
| 19668 | FL | MD | Geriatric Pharmacist |
| 19688 | FL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martinez Drug Store, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Hialeah, FL
- NPI 1659465342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643241600000",
"number": "1063081818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1437 LANTANA DR",
"city": "WESTON",
"state": "FL",
"postal_code": "333263601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "874 E 41ST ST",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330132455",
"telephone_number": "305-693-0441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEON",
"first_name": "IRENE",
"middle_name": "C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-24",
"last_updated": "2022-01-27",
"certification_date": "2022-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "FL",
"license": "19668",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "19688",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1659465342",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.