Individual provider Active NPI

Raul Leon

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1891201323
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9287516 Issued in FL
Practice address
1501 NW 36TH St
Miami, FL 33142-5559
Phone
(786) 378-8200
Fax
(305) 907-5871
NPI assigned
Dec 20, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9287516 FL Primary

Addresses

Primary practice location

1501 NW 36TH St
Miami, FL 33142-5559

Mailing address

13228 NW 11TH St
Miami, FL 33182-2247
Phone (786) 201-4296

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
I20191122001075 FL Practitioner - Nurse Practitioner 9739511155 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9287516FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centers of Medical Excellence, LLC CurrentSince Jun 1, 2021 Accepting new patients

Locations

7925 NW 12th St
Ste 201
Doral, FL 33126

6401 NW 27th Ave
Miami, FL 33147
Phone (305) 698-8434

1501 NW 36th St
Miami, FL 33142
Phone (786) 260-8151

1176 SW 67th Ave
Miami, FL 33144
Phone (305) 359-9838

5850 W Flagler St
Miami, FL 33144
Phone (305) 263-9590

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": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1891201323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13228 NW 11TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331822247",
            "telephone_number": "786-201-4296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 NW 36TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331425559",
            "telephone_number": "786-378-8200",
            "fax_number": "305-907-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON",
        "first_name": "RAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-20",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9287516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.