Individual provider Active NPI

Leidy J Porres

  • Nutritionist
  • Miami, FL
National Provider Identifier
1215632393
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
Practice address
9940 SW 62ND St
Miami, FL 33173-1432
Phone
(786) 704-6147
NPI assigned
Mar 30, 2023
Last updated
Mar 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X NU Primary

Addresses

Primary practice location

9940 SW 62ND St
Miami, FL 33173-1432

Mailing address

9940 SW 62ND St
Miami, FL 33173-1432
Phone (786) 704-6147

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

NPI Registry JSON

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1215632393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9940 SW 62ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331731432",
            "telephone_number": "786-704-6147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9940 SW 62ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331731432",
            "telephone_number": "786-704-6147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORRES",
        "first_name": "LEIDY",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.