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General NPI Number Information
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NPI Number | 1396785416
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Entity Type | Individual
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Provider Name | LEANDRO LUIS OTERO MD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 15529 BULL RUN RD
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City | MIAMI LAKES
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State | FL
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Zip | 33014-7004
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Country | US
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Telephone | 305-328-8922
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Fax | 786-224-6489
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Provider Business Mailing Address
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Address Line | 7925 NW 12TH ST STE 201
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City | DORAL
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State | FL
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Zip | 33126-1821
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Country | US
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Telephone | 305-874-3909
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Fax | 305-874-3916
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME88625
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License Number State | FL
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