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General NPI Number Information
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NPI Number | 1700723665
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Entity Type | Individual
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Provider Name | JESEY HERNANDEZ LEON SA-C
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Gender | Male
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 179 W 9TH ST APT 1A
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City | HIALEAH
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State | FL
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Zip | 33010-4001
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Country | US
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Telephone | 813-403-1715
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Fax |
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Provider Business Mailing Address
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Address Line | 179 W 9TH ST APT 1A
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City | HIALEAH
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State | FL
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Zip | 33010-4001
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Country | US
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Telephone | 813-403-1715
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 23-758
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License Number State | WI
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