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NPI Code Detail

MEDICARE: LEON MEDICAL LLC

MEDICARE: LEON MEDICAL LLC
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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1457201147
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEON MEDICAL LLC
Provider Business Mailing Address
First Line : 3430 E FLAMINGO RD STE 104
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-5070
Country : US
Telephone Number : 702-331-2094
Fax Number : 702-331-3612
Provider Business Practice Location Address
First Line : 3430 E FLAMINGO RD STE 104
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-5070
Country : US
Telephone Number : 702-331-2094
Fax Number : 702-331-3612
Authorized Official
Title or Position : OWNER
Name : AMAURI SANTIAGO ROSALES PONCE DE LEON
Credential : NP
Telephone Number : 702-331-2094
Provider Enumeration Date : 02/02/2026
Last Update Date : 03/01/2026

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Directions to “LEON MEDICAL LLC ” Practice Location

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