Individual provider Active NPI

Lianet Delia Leon Oliveros

  • Family Nurse Practitioner
  • Lehigh Acres, FL
National Provider Identifier
1306433362
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11010696 Issued in FL
Practice address
1530 Lee Blvd Ste 1400
Lehigh Acres, FL 33936-4887
Phone
(239) 368-7310
Fax
(239) 368-7312
NPI assigned
Dec 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11010696 FL Primary

Addresses

Primary practice location

1530 Lee Blvd Ste 1400
Lehigh Acres, FL 33936-4887

Mailing address

1530 Lee Blvd Ste 1400
Lehigh Acres, FL 33936-4887
Phone (239) 368-7310

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210929003027 FL Practitioner - Nurse Practitioner 5799182093 Reassigns benefits to 2 organizations
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11010696FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carmona Medical Care Inc CurrentSince Mar 1, 2022 Accepting new patients
Castillo'S MD Services, LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

2307 Bolado Pkwy
Cape Coral, FL 33990
Phone (239) 424-8122

1530 Lee Blvd
Ste 1400
Lehigh Acres, FL 33936
Phone (239) 368-7310

Interoperability endpoints

  • Direct secure messaging: lianet.leon.1@15088.direct.athenahealth.com

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": "1608768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1306433362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 LEE BLVD STE 1400",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339364887",
            "telephone_number": "239-368-7310",
            "fax_number": "239-368-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 LEE BLVD STE 1400",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339364887",
            "telephone_number": "239-368-7310",
            "fax_number": "239-368-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON OLIVEROS",
        "first_name": "LIANET",
        "middle_name": "DELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-24",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11010696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

Verify at the official NPI Registry.