MEDICARE: LEON CAMILO URIBE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QS0010X	Sports Medicine (Family Medicine) Physician	ME100547	FL
2	207Q00000X	Family Medicine Physician	ME100547	FL

General Provider Information

NPI Number	:	1023120664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEON CAMILO URIBE M.D.

Provider Business Mailing Address
First Line	:	4601 N CONGRESS AVE STE 107
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3381
Country	:	US
Telephone Number	:	561-652-8651
Fax Number	:

Provider Business Practice Location Address
First Line	:	4601 N CONGRESS AVE STE 107
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3381
Country	:	US
Telephone Number	:	561-652-8651
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	12/10/2025

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Directions to “ LEON CAMILO URIBE M.D.” Practice Location

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