MEDICARE: DR. HECTOR M 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	2084P0804X	Child & Adolescent Psychiatry Physician	ME89164	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	267132	OTHER	FL	WELLCARE / HEALTHEASE
2	37905	OTHER	FL	BLUE CROSS & BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821023268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HECTOR M DE LEON M.D.

Provider Business Mailing Address
First Line	:	1799 SALK AVE
Second Line	:
City	:	TAVARES
State	:	FL
Zip	:	32778-4311
Country	:	US
Telephone Number	:	352-742-8300
Fax Number	:	352-742-8305

Provider Business Practice Location Address
First Line	:	1799 SALK AVE
Second Line	:
City	:	TAVARES
State	:	FL
Zip	:	32778-4311
Country	:	US
Telephone Number	:	352-742-8300
Fax Number	:	352-742-8305

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	11/10/2025

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