Physician Compare National (NPI:1093850927)

HEALTHCARE PROVIDER: JORGE J LEAL MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1093850927
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1951427442
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100921001252
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LEAL
	Individual professional last name
Provider First Name	JORGE
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1974
	Individual professional's medical school graduation year
Primary Specialty	UROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	825 N COURTENAY PKWY
	Group Practice or individual's line 1 address
City	MERRITT ISLAND
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	329534652
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100092
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WUESTHOFF MEDICAL CENTER ROCKLEDGE
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y