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NPI Code Detail

MEDICARE: DR. MARLEN LEON MD

MEDICARE: DR. MARLEN 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
1207W00000XOphthalmology Physician067673GA
2207W00000XOphthalmology PhysicianME115732FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699935320
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARLEN LEON MD
Provider Business Mailing Address
First Line : 4708 S FLORIDA AVE
Second Line :
City : LAKELAND
State : FL
Zip : 33813-2165
Country : US
Telephone Number : 305-878-3203
Fax Number :
Provider Business Practice Location Address
First Line : 4708 S FLORIDA AVE
Second Line :
City : LAKELAND
State : FL
Zip : 33813-2165
Country : US
Telephone Number : 863-858-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2008
Last Update Date : 11/02/2016

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Directions to “ DR. MARLEN LEON MD” Practice Location

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