MEDICARE: DR. SEBASTIAN RODRIGUEZ LEON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	10974	PR

General Provider Information

NPI Number	:	1558387332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEBASTIAN RODRIGUEZ LEON MD

Provider Business Mailing Address
First Line	:	PO BOX 195623
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00919-5623
Country	:	US
Telephone Number	:	787-450-1151
Fax Number	:

Provider Business Practice Location Address
First Line	:	HF16 CALLE LIZZIE GRAHAM
Second Line	:
City	:	TOA BAJA
State	:	PR
Zip	:	00949-3634
Country	:	US
Telephone Number	:	787-795-2935
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	09/25/2012

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