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Deactivated NPI 1003801911 Deactivated / Inactive NPI Male Practitioner

Dr. Leonides Carballosa , MD

Specialist • Miami, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Leonides Carballosa has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 16, 2005
NPI Deactivation Date March 23, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Leonides Carballosa, MD was a registered Specialist practicing in Miami, FL. Throughout an active medical career spanning 1 years, Dr. Carballosa provided care at the practice location at 7900 NW 27TH AVE until profile deactivation on 2006-03-23.

Practice Location & Contact Primary Location

Practice Address

7900 Nw 27th Ave
Suite D-10

Miami, FL 331474909

Telephone 3054034003
Fax 3054034006
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Miami, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 41.5 Yrs
State Avg: 37.8 Yrs
Regional Practice Density
253 Specialists

Practicing in Miami, FL (3036 Statewide)

Telehealth Adoption Rate
2.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License FL ME49239

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Venante Servalis , ARNP

Nurse Practitioner - Family

NPI 1265894653

Advanced Registered Nurse Practitioner

Dr. Moris Laca , MD

General Practice

NPI 1518200609

Doctor of Medicine (M.D.)

Grethell Estrada , ARNP, FNP-BC

Nurse Practitioner - Family

NPI 1750825543

Advanced Registered Nurse Practitioner, Family Nurse Practitioner (Board Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
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NPI Profile Deactivated June 14, 2021

Record deactivated on June 14, 2021

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Updated Practice Location October 07, 2019

Registered at 5378 W 16TH AVE, HIALEAH, FL 330122165 (Tel: 3058204101)

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 07, 2019

Pediatrics (License #ME49239 in FL)

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Updated Practice Location April 20, 2015

Registered at 7900 NW 27TH AVE, SUITE D-10, MIAMI, FL 331474909 (Tel: 3054034003)

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Updated Business Mailing Address April 20, 2015

Registered at 14900 EGAN LN, MIAMI LAKES, FL 330142714 (Tel: 3055052780)

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Provider Name / Credentials Updated April 20, 2015

Recorded as LEONIDES CARBALLOSA, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 20, 2015

Specialist (License #ME49239 in FL)

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NPI Profile Reactivated March 27, 2006

Record officially reactivated for active practice on March 27, 2006

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NPI Profile Deactivated March 23, 2006

Record deactivated on March 23, 2006

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Initial NPI Registration & Enumeration September 16, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1003801911
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 16, 2005
Last Update: April 20, 2015
Deactivation Date: March 23, 2006

Mailing Address

14900 Egan Ln

Miami Lakes, FL 330142714

Phone: 3055052780

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.