Individual provider Active NPI

Marissa Nicole Leslie

  • Developmental Therapist
  • North Miami Beach, FL
National Provider Identifier
1437648599
Registry record updated May 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
21421 Highland Lakes Blvd
North Miami Beach, FL 33179-1660
Phone
(305) 450-6686
NPI assigned
May 4, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary

Addresses

Primary practice location

21421 Highland Lakes Blvd
North Miami Beach, FL 33179-1660

Mailing address

21421 Highland Lakes Blvd
North Miami Beach, FL 33179-1660
Phone (305) 450-6686

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": "1525392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525392000000",
    "number": "1437648599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21421 HIGHLAND LAKES BLVD",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331791660",
            "telephone_number": "305-450-6686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21421 HIGHLAND LAKES BLVD",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331791660",
            "telephone_number": "305-450-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "MARISSA",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-04",
        "last_updated": "2018-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2018; 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.