Individual provider Active NPI

Leonita Rosalyn Yacoba Bray, MD

  • Pediatrics Physician
  • Sanford, FL
National Provider Identifier
1952962417
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME153804 Issued in FL
Practice address
1403 Medical Plaza Dr Ste 104
Sanford, FL 32771-1047
Phone
(407) 249-1234
Fax
(407) 249-1755
NPI assigned
Jun 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X ME153804 FL Primary

Addresses

Primary practice location

1403 Medical Plaza Dr Ste 104
Sanford, FL 32771-1047

Mailing address

1403 Medical Plaza Dr Ste 104
Sanford, FL 32771-1047
Phone (407) 249-1234

Other practice location 1

760 Broadway
Department of Pediatrics Rm 6B23
Brooklyn, NY 11206
Phone (718) 963-7956

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME153804FLMDPediatrics Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1952962417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 MEDICAL PLAZA DR STE 104",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711047",
            "telephone_number": "407-249-1234",
            "fax_number": "407-249-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 MEDICAL PLAZA DR STE 104",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711047",
            "telephone_number": "407-249-1234",
            "fax_number": "407-249-1755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Broadway",
            "address_2": "Department of Pediatrics Rm 6B23",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11206",
            "country_code": "US",
            "telephone_number": "718-963-7956",
            "fax_number": "718-963-7957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAY",
        "first_name": "LEONITA",
        "middle_name": "ROSALYN YACOBA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME153804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.

Verify at the official NPI Registry.