Active NPI
Leyana Candice Ambrose
- Developmental Therapist
- Melbourne, FL
National Provider Identifier
1700697208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 325 E University Blvd Apt 67
Melbourne, FL 32901-7075 - Phone
- (585) 503-5902
- NPI assigned
- Jan 15, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Primary | ||
| Early Intervention Provider Agency | 252Y00000X |
Addresses
Primary practice location
325 E University Blvd Apt 67
Melbourne, FL 32901-7075
Mailing address
325 E University Blvd Apt 67
Melbourne, FL 32901-7075
Phone (585) 503-5902
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": "1736899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736899200000",
"number": "1700697208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 E UNIVERSITY BLVD APT 67",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329017075",
"telephone_number": "585-503-5902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 E UNIVERSITY BLVD APT 67",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329017075",
"telephone_number": "585-503-5902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMBROSE",
"first_name": "LEYANA",
"middle_name": "CANDICE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-15",
"last_updated": "2025-01-15",
"certification_date": "2025-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.