Leddataliz Pedrogo, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN5198865 Issued in FL

Practice address

4762 Breezer Dr
Lake Wales, FL 33859-5447

Phone

(407) 724-4853

NPI assigned

Mar 30, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 10

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1396011748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 ELLINGTON DR",
            "city": "DUNDEE",
            "state": "FL",
            "postal_code": "338384633",
            "telephone_number": "407-724-4853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4762 BREEZER DR",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338595447",
            "telephone_number": "407-724-4853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDROGO",
        "first_name": "LEDDATALIZ",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-30",
        "last_updated": "2022-07-21",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "FL",
            "license": "PN5198865",
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "FL",
            "license": "PN5198865",
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "FL",
            "license": "PN5198865",
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": "FL",
            "license": "PN5198865",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5198865",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "PN5198865",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "FL",
            "license": "PN5198865",
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "FL",
            "license": "PN5198865",
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "FL",
            "license": "PN5198865",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": "PN5198865",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neeshi Rakesh Patel, DMD
• Pranav K Patel
• Priyanka Vashi Patel, PHARM. D
• PDT Compassionate Care & Helping Hands LLC.
• Willard Cail Pearce Jr., O.D.
• Melisa Andrea Penafiel Balladares
• Samuel Thomas Pero IV, D.M.D.
• Tina Perry, COTA
• Lisa Marie Peto, APRN FNP-C
• Karen Phillipps

• Licensed Practical Nurse in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• Licensed Practical Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.