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Dr. Carlos A Leon
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NPI Number Detailed Information
Provider Information:
| Name: | Dr. Carlos A Leon |
| Gender: | M |
| Provider License Number If Given: | ME56274 |
NPI Information:
| NPI: | 1679576870 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 5/23/2005 |
| Last Update Date: | 5/28/2014 |
Provider Business Mailing Address:
| Address: | 2300 PARK AVENUE SUITE 101-B Orange Park, FL 32073 |
| Phone Number: | 9042640088 |
| Fax Number: | 9042640099 |
Provider Business Practice Location Address:
| Address: | 2300 PARK AVENUE SUITE 101-B Orange Park, FL 32073 |
| Phone Number: | 9042640088 |
| Fax Number: | 9042640099 |
Provider Taxonomy:
| Primary: | 207RC0000X |
| Secondary (if any): | 207RC0000X |
| State: | FL |
