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NPI Code Detail

MEDICARE: DIANALYN ESCOBER DE LEON MD

MEDICARE:   DIANALYN ESCOBER DE 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1144536756
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANALYN ESCOBER DE LEON MD
Provider Business Mailing Address
First Line : 2400 KATHLEEN RD
Second Line :
City : LAKELAND
State : FL
Zip : 33810-3077
Country : US
Telephone Number : 863-687-1302
Fax Number :
Provider Business Practice Location Address
First Line : 2400 KATHLEEN RD
Second Line :
City : LAKELAND
State : FL
Zip : 33810-3077
Country : US
Telephone Number : 863-687-1302
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2010
Last Update Date : 03/20/2024

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Directions to “ DIANALYN ESCOBER DE LEON MD” Practice Location

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