Individual provider Active NPI

Pedro E. Leon Alfonso

  • Case Manager/Care Coordinator
  • Doral, FL
National Provider Identifier
1184199739
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
CBHCM100425 Issued in FL
Practice address
1905 NW 82ND Ave
Doral, FL 33126-1011
Phone
(786) 420-5924
NPI assigned
Oct 10, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X CBHCM100425 FL Primary

Addresses

Primary practice location

1905 NW 82ND Ave
Doral, FL 33126-1011

Mailing address

8425 NW 169TH Ter
Miami Lakes, FL 33016-6160
Phone (786) 714-9842

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

LicenseStateTypeSpecialty
CBHCM100425FLMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Psychwell. Inc Case Manager/Care Coordinator PastSince Jun 1, 2024 Accepting new patients
Helping Hands International Foundation Inc PastSince Apr 21, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1184199739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8425 NW 169TH TER",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330166160",
            "telephone_number": "786-714-9842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 NW 82ND AVE",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261011",
            "telephone_number": "786-420-5924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON ALFONSO",
        "first_name": "PEDRO",
        "middle_name": "E.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-10",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "CBHCM100425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.