Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 18183 | PR |
N | 2080P0205X | Pediatric Endocrinologist | ME104962 | FL |
NPI | 1437353356 |
---|---|
Provider Name | Dr. Carlos Alberto Leyva |
First Address | San Juan, PR 00923-3003 |
Second Address | San Juan, PR 00923-3003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 12/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
18183 | STATE LICENSE (01) | PR |