Basic Information
| Provider Information | |||||||||
| NPI: | 1740352442 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ORLANDO J LEON MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9000 SW 87TH CT | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331762231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055966700 | ||||||||
| FaxNumber: | 3055989779 | ||||||||
| Practice Location | |||||||||
| Address1: | 9000 SW 87 CT | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331762297 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055966700 | ||||||||
| FaxNumber: | 3055989779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2006 | ||||||||
| LastUpdateDate: | 11/23/2011 | ||||||||
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| AuthorizedOfficialLastName: | LEON | ||||||||
| AuthorizedOfficialFirstName: | ORLANDO | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3055966700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 269980000 | 05 | FL | MEDICAID |