Individual provider Active NPI

Leonidas Fenelon, RRT

  • Registered Respiratory Therapist
  • Miramar, FL
National Provider Identifier
1407100530
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Respiratory TherapistTaxonomy code 227900000X
License
RT11776 Issued in FL
Practice address
7531 Fairway Blvd
Miramar, FL 33023-6500
Phone
(954) 383-1851
NPI assigned
Oct 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Respiratory Therapist 227900000X RT11776 FL Primary
General Care Certified Respiratory Therapist 2278G1100X RT11776 FL

Addresses

Primary practice location

7531 Fairway Blvd
Miramar, FL 33023-6500

Mailing address

7531 Fairway Blvd
Miramar, FL 33023-6500
Phone (954) 383-1851

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
RT11776FLMDGeneral Care Certified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lungevity Healthcare, LLC Past Accepting new patients

Organizations & group practices 1

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": "1351209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1407100530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7531 FAIRWAY BLVD",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330236500",
            "telephone_number": "954-383-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7531 FAIRWAY BLVD",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330236500",
            "telephone_number": "954-383-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENELON",
        "first_name": "LEONIDAS",
        "credential": "RRT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-26",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": "FL",
            "license": "RT11776",
            "primary": true
        },
        {
            "code": "2278G1100X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified, General Care",
            "state": "FL",
            "license": "RT11776",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; 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.