Leidi Maylan Pedraza Gonzalez, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME168881 Issued in FL

Practice address

19615 State Road 7 Ste 32
Boca Raton, FL 33498-4700

Phone

(561) 477-7000

Fax

(561) 477-7707

NPI assigned

Jan 25, 2021

Last updated

Jun 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lifetime Solutions Agency, LLC

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1578046215

  Case Management

  NPD (past)
• Lifetime Solutions Agency, LLC

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1821751769

  Case Management

  NPD (past)
• Saltzman, Tanis, Pittel, Levin and Jacobson

  dba Pediatric Associates

  • Pediatrics Physician
  • Coconut Creek, FL
  • NPI 1891903464
  NPD (past)
• Saltzman, Tanis, Pittell, Levin and Jacobson

  dba Pediatric Associates

  • Pediatrics Physician
  • Hollywood, FL
  • NPI 1639138480
  NPD (past)
• Saltzman, Tanis, Pittell, Levin and Jacobson, LLC

  dba Pediatric Associates

  • Pediatrics Physician
  • Coral Springs, FL
  • NPI 1316155096
  NPD (past)

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1255921185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD STE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243923",
            "telephone_number": "561-477-7000",
            "fax_number": "561-477-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19615 STATE ROAD 7 STE 32",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334984700",
            "telephone_number": "561-477-7000",
            "fax_number": "561-477-7707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5810 Coral Ridge Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330763377",
            "country_code": "US",
            "telephone_number": "954-414-7700",
            "fax_number": "954-840-0850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9120A Wiles Rd",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330671993",
            "country_code": "US",
            "telephone_number": "954-341-0074",
            "fax_number": "954-345-3474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4570 Lyons Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Coconut Creek",
            "state": "FL",
            "postal_code": "330733481",
            "country_code": "US",
            "telephone_number": "954-971-3210",
            "fax_number": "954-971-3427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDRAZA GONZALEZ",
        "first_name": "LEIDI",
        "middle_name": "MAYLAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME168881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatrix Medical Group of Florida Inc
• Pediatrix Medical Group of Florida Inc
• Pediatrix Medical Group of Florida Inc
• Pediatrix Medical Group of Florida Inc
• Pediatrix Medical Group of Florida, Inc
• Diego Pedraza
• Casey Vey Pedro, DMD
• Jamily Pedro, D.M.D
• Beverly Joy Pedroche, PSY.D.
• Jasmine Peebles

• Pediatrics Physician in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.