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NPI 1639477037

NPI 1639477037 : LEON HEALTH SERVICES INC : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1639477037
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    Entity Type          |    Organization 
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    Legal Business Name  |    LEON HEALTH SERVICES INC 
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Dates
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    Enumeration Date     |    03/09/2011
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    Last Update Date     |    03/09/2011
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Provider Practice Location Address
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    Address Line         |    1675 SW 25TH AVE 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33145-2048
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    Country              |    US
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    Telephone            |    786-715-8594
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1675 SW 25TH AVE 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33145-2048
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    Country              |    US
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    Telephone            |    786-715-8594
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     MARIE  LEON-FERNANDEZ 
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    Credential           |    
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    Telephone            |    786-715-8594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    310400000X
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    Taxonomy Name        |    Assisted Living Facility
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    License Number       |    AL-11776
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    License Number State |    FL
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