Healthcare Provider Details

I. General information

NPI: 1104613686
Provider Name (Legal Business Name): KRIZIA M TOSADO DE LEON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 CALLE SANTA CRUZ STE 410
BAYAMON PR
00961-6942
US

IV. Provider business mailing address

13 WASHINGTONIAN DR
DORADO PR
00646-4729
US

V. Phone/Fax

Practice location:
  • Phone: 787-269-8611
  • Fax:
Mailing address:
  • Phone: 787-310-5158
  • Fax: 787-310-5158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number25066
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: