Active NPI
Raiza De Leon, R.N
- Pharmacotherapy Pharmacist
- Hialeah, FL
National Provider Identifier
1184053530
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Dec 19, 2019.
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- PH27197
- Practice address
- 4920 E 4TH Ave
Hialeah, FL 33013-1509 - Phone
- (305) 364-8858
- NPI assigned
- Nov 6, 2013
- 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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | PH27197 | FL | Primary |
Addresses
Primary practice location
4920 E 4TH Ave
Hialeah, FL 33013-1509
Mailing address
4920 E 4TH Ave
Hialeah, FL 33013-1509
Phone (305) 364-8858
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PH27197 | Other | FL | BOARD OF PHARMACY |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH27197 | FL | MD | Pharmacotherapy Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J&S Pharmacy Ans Discount, 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 1194154559
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383696000000",
"number": "1184053530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4920 E 4TH AVE",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330131509",
"telephone_number": "305-364-8858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4920 E 4TH AVE",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330131509",
"telephone_number": "305-364-8858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LEON",
"first_name": "RAIZA",
"credential": "R.N",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-06",
"last_updated": "2013-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "FL",
"license": "PH27197",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY",
"identifier": "PH27197",
"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 Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.