MEDICARE: CARLOS A LECHE 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	207RC0000X	Cardiovascular Disease Physician	ME93159	FL

General Provider Information

NPI Number	:	1417956707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS A LECHE MD

Provider Business Mailing Address
First Line	:	1026 E BRANDON BLVD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-5509
Country	:	US
Telephone Number	:	813-413-1455
Fax Number	:	813-413-1454

Provider Business Practice Location Address
First Line	:	1026 E BRANDON BLVD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-5509
Country	:	US
Telephone Number	:	813-413-1455
Fax Number	:	813-413-1454

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	11/08/2023

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Directions to “ CARLOS A LECHE MD” Practice Location

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