MEDICARE: MRS. SYLVETTE DE LEON 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	208D00000X	General Practice Physician	8193	PR

General Provider Information

NPI Number	:	1730182833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SYLVETTE DE LEON M.D.

Provider Business Mailing Address
First Line	:	D27 AVE CRISALIDA
Second Line	:	URB TORREMOLINOS
City	:	GUAYNABO
State	:	PR
Zip	:	00969-3619
Country	:	US
Telephone Number	:	787-751-3845
Fax Number	:	787-751-3845

Provider Business Practice Location Address
First Line	:	CENTRO COMERCIAL RIO PIEDRAS HEIGHTS
Second Line	:	CALLE PARANA 1689 OFIC #5
City	:	SAN JUAN
State	:	PR
Zip	:	00926
Country	:	US
Telephone Number	:	787-751-3845
Fax Number	:	787-751-3845

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	01/13/2011

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