MEDICARE: MR. FELIX IVAN LEON MD

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	207R00000X	Internal Medicine Physician	4209	PR
2	207RP1001X	Pulmonary Disease Physician	4209	PR

General Provider Information

NPI Number	:	1073505046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FELIX IVAN LEON MD

Provider Business Mailing Address
First Line	:	PO BOX 192054
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00919-2054
Country	:	US
Telephone Number	:	787-754-8489
Fax Number	:	787-751-0861

Provider Business Practice Location Address
First Line	:	1724 CALLE YANGTZE
Second Line	:	RIO PIEDRAS HEIGHTS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-3104
Country	:	US
Telephone Number	:	787-754-8489
Fax Number	:	787-751-0861

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	09/08/2010

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