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General NPI Number Information
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NPI Number | 1871658138
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Entity Type | Individual
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Provider Name | SOCRATES E LEDESMA M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6950 NW 41ST ST
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City | MIAMI
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State | FL
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Zip | 33166-6815
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Country | US
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Telephone | 305-470-2877
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Fax | 305-470-2878
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Provider Business Mailing Address
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Address Line | 14241 SW 18TH ST
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City | MIAMI
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State | FL
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Zip | 33175-7062
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Country | US
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Telephone |
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | ME29716
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License Number State | FL
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