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NPI Code Detail

MEDICARE: DR. KEILA THAMAR TOSADO DE LEON M.D

MEDICARE: DR. KEILA THAMAR TOSADO 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
1208000000XPediatrics PhysicianACN483FL
2208D00000XGeneral Practice Physician17316PR
3208D00000XGeneral Practice PhysicianACN483FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ACN483OTHERFLMEDICINE DOCTOR LIC

General Provider Information

NPI Number : 1881843860
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEILA THAMAR TOSADO DE LEON M.D
Provider Business Mailing Address
First Line : 6675 WESTWOOD BLVD STE 475
Second Line :
City : ORLANDO
State : FL
Zip : 32821-6027
Country : US
Telephone Number : 407-845-0330
Fax Number : 888-972-1752
Provider Business Practice Location Address
First Line : 4729 US HIGHWAY 98 S STE 201
Second Line :
City : LAKELAND
State : FL
Zip : 33812-4336
Country : US
Telephone Number : 863-646-9663
Fax Number : 863-646-9664
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2008
Last Update Date : 06/02/2023

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