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General NPI Number Information
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NPI Number | 1487819256
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Entity Type | Individual
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Provider Name | NANETTE MICHELLE DE LEON M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/22/2008
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | SAN JUAN HEALTH CENTER SUITE 701 150 AVE DE DIEGO
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City | SAN JUAN
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State | PR
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Zip | 00907
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Country | US
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Telephone | 939-545-8402
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Fax | 939-545-8439
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Provider Business Mailing Address
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Address Line | 1803 CALLE DIAMELA URB. SANTA MARIA
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City | SAN JUAN
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State | PR
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Zip | 00927-6342
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Country | US
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Telephone | 787-764-4060
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 17637
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License Number State | PR
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