MEDICARE: AUGUSTO R. DE LEON JR. M.D.

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	173000000X	Legal Medicine	ME0066795	FL
2	207R00000X	Internal Medicine Physician	ME0066795	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982664165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUGUSTO R. DE LEON JR. M.D.

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:	305-500-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 CYPRESS POINT PKWY
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-7528
Country	:	US
Telephone Number	:	386-586-7005
Fax Number	:	844-867-3940

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	02/13/2026

Similar Medicare Providers

1275581829 — DR. LIDYA MARGARITA LATABAN-LOPEZ MD
Practice Location Address:

20 CYPRESS POINT PKWY STE A
PALM COAST, FL
32164-7528

Practice Phone: 386-586-7005
Practice Fax: 844-867-3940

1003848565 — DR. MARY K HURD QUINONES MD
Practice Location Address:

20 CYPRESS POINT PKWY
PALM COAST, FL
32164-7528

Practice Phone: 386-586-7005
Practice Fax: 844-867-3940

1093149569 — MRS. SUZANNE KORUM ARNP-BC
Practice Location Address:

20 CYPRESS POINT PKWY STE A
PALM COAST, FL
32164-7528

Practice Phone: 386-586-7005
Practice Fax: 844-867-3940

1093142515 — MRS. VENUS M. VALLIERE ARNP BC
Practice Location Address:

20 CYPRESS POINT PKWY STE A
PALM COAST, FL
32164-7528

Practice Phone: 386-586-7005
Practice Fax: 844-867-3940

1417125196 — TRACY A. ZEIL RN
Practice Location Address:

4591 PALM BROOKE CIR
WEST PALM BEACH, FL
33417-7528

Practice Phone: 860-463-0453
Practice Fax:

1588020069 — TOTAL RENAL CARE, INC.
Practice Location Address:

80 PINNACLES DR , STE 1000
PALM COAST, FL
32164-2916

Practice Phone: 386-586-7399
Practice Fax: 386-586-2975

Directions to “ AUGUSTO R. DE LEON JR. M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.