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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

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