Provider Demographics
NPI:1861292138
Name:VIEYRA-DELGADO, LESLIE G
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:G
Last Name:VIEYRA-DELGADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28458 SW 133RD CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7532
Mailing Address - Country:US
Mailing Address - Phone:786-217-3820
Mailing Address - Fax:
Practice Address - Street 1:28458 SW 133RD CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7532
Practice Address - Country:US
Practice Address - Phone:786-217-3820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038163363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care