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General NPI Number Information
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NPI Number | 1447593959
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Entity Type | Organization
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Legal Business Name | JOSE M LEON MD PA
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Dates
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Enumeration Date | 04/03/2013
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Last Update Date | 04/03/2013
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Provider Practice Location Address
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Address Line | 5640 W ATLANTIC BLVD
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City | MARGATE
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State | FL
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Zip | 33063-4523
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Country | US
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Telephone | 954-974-4414
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Fax | 954-975-7239
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Provider Business Mailing Address
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Address Line | 5640 W ATLANTIC BLVD
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City | MARGATE
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State | FL
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Zip | 33063-4523
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Country | US
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Telephone | 954-974-4414
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Fax | 954-975-7239
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JOSE M. LEON
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Credential | MD
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Telephone | 954-974-4414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0025157
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License Number State | FL
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