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General NPI Number Information
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NPI Number | 1255075149
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Entity Type | Individual
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Provider Name | FAURE DELGADO LEON MD
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Gender | Male
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Dates
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Enumeration Date | 04/26/2022
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 703 N FLAMINGO RD FL 33028
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1006
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Country | US
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Telephone | 954-844-4491
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Fax |
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Provider Business Mailing Address
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Address Line | 8810 SW 123RD CT APT M-209
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City | MIAMI
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State | FL
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Zip | 33186-1947
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Country | US
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Telephone | 754-246-7568
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11019298
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9523373
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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