MEDICARE: DR. ROBERTO A LEON FERRE 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	207R00000X	Internal Medicine Physician	40765	IA
2	207R00000X	Internal Medicine Physician	R-8784	IA
3	207RX0202X	Medical Oncology Physician	57809	MN

General Provider Information

NPI Number	:	1427361377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERTO A LEON FERRE M.D.

Provider Business Mailing Address
First Line	:	200 1ST ST SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55905-0001
Country	:	US
Telephone Number	:	507-284-2511
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 1ST ST SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55905-2209
Country	:	US
Telephone Number	:	507-284-2511
Fax Number	:

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

Provider Enumeration Date	:	07/21/2010
Last Update Date	:	08/18/2020

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