Basic Information
| Provider Information | |||||||||
| NPI: | 1275706822 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RIZALINA LEUTERIO MD P A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 711 BEVILLE RD | ||||||||
| Address2: | |||||||||
| City: | SOUTH DAYTONA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321191823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3867608116 | ||||||||
| FaxNumber: | 3867600532 | ||||||||
| Practice Location | |||||||||
| Address1: | 711 BEVILLE RD | ||||||||
| Address2: | |||||||||
| City: | SOUTH DAYTONA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321191823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3867608116 | ||||||||
| FaxNumber: | 3867600532 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2008 | ||||||||
| LastUpdateDate: | 10/21/2008 | ||||||||
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| AuthorizedOfficialLastName: | LEUTERIO | ||||||||
| AuthorizedOfficialFirstName: | RIZALINA | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | DR / OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3867608116 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D.,PA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ME0061585 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.