Individual provider Active NPI

Tiffany Shana Leon, NP-BC

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1558030080
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11028821 Issued in FL
Practice address
8501 SW 124TH Ave Ste 211
Miami, FL 33183-4633
Phone
(305) 595-6488
NPI assigned
Sep 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN244576 GA
Registered Nurse 163W00000X 9353329 FL
Family Nurse Practitioner 363LF0000X RN244576 GA
Family Nurse Practitioner 363LF0000X 11028821 FL Primary

Addresses

Primary practice location

8501 SW 124TH Ave Ste 211
Miami, FL 33183-4633

Mailing address

2055 SE 14TH CT
Homestead, FL 33035-1947
Phone (305) 680-8777

Other practice location 1

3320 Old Jefferson Rd Bldg 700
Athens, GA 30607-1465
Phone (706) 353-2990

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
I20241024004304 FL Practitioner - Nurse Practitioner 5496288714 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9353329FLMDRegistered Nurse
RN244576GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Susan Fox, D.O., LLC CurrentSince Oct 28, 2024 Accepting new patients
Center for Womens Health and Wellness LLC CurrentSince Oct 2, 2025 Accepting new patients
Pavilion for Women's Care LLC Past Accepting new patients

Locations

8501 SW 124th Ave
Ste 207
Miami, FL 33183
Phone (305) 279-1500

8501 SW 124th Ave
Ste 211
Miami, FL 33183
Phone (305) 595-6488

Organizations & group practices 3

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": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1558030080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 SE 14TH CT",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330351947",
            "telephone_number": "305-680-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 SW 124TH AVE STE 211",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331834633",
            "telephone_number": "305-595-6488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3320 Old Jefferson Rd Bldg 700",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306071465",
            "country_code": "US",
            "telephone_number": "706-353-2990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEON",
        "first_name": "TIFFANY",
        "middle_name": "SHANA",
        "credential": "NP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN244576",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9353329",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN244576",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11028821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.