Active NPI
Nicolette Marie Leiva, DPT
- Physical Therapist
- Deland, FL
National Provider Identifier
1093373359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT34369
- Practice address
- 451 S Amelia Ave
Deland, FL 32724-5917 - Phone
- (386) 734-8614
- NPI assigned
- Jun 2, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT34369 | FL | Primary |
Addresses
Primary practice location
451 S Amelia Ave
Deland, FL 32724-5917
Mailing address
3865 Grandpine Way Apt 211
Casselberry, FL 32707-4353
Phone (786) 973-3030
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT34369 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabcare Group East, LLC | 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.
-
- Rehabilitation Clinic/Center
- Shalimar, FL
- NPI 1407382278
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559433600000",
"number": "1093373359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3865 GRANDPINE WAY APT 211",
"city": "CASSELBERRY",
"state": "FL",
"postal_code": "327074353",
"telephone_number": "786-973-3030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 S AMELIA AVE",
"city": "DELAND",
"state": "FL",
"postal_code": "327245917",
"telephone_number": "386-734-8614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEIVA",
"first_name": "NICOLETTE",
"middle_name": "MARIE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-02",
"last_updated": "2019-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT34369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.