Basic Information
Provider Information
NPI: 1396984464
EntityType: 2
ReplacementNPI:  
OrganizationName: RAMON LEON MD LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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Mailing Information
Address1: 7540 SW 61ST AVE
Address2:  
City: SOUTH MIAMI
State: FL
PostalCode: 331435012
CountryCode: US
TelephoneNumber: 3056668691
FaxNumber: 3055528633
Practice Location
Address1: 7540 SW 61ST AVE
Address2:  
City: SOUTH MIAMI
State: FL
PostalCode: 331435012
CountryCode: US
TelephoneNumber: 3056668691
FaxNumber: 3055528633
Other Information
ProviderEnumerationDate: 02/13/2009
LastUpdateDate: 02/13/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: LEON
AuthorizedOfficialFirstName: RAMON
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 3056668691
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XME92409FLY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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