Provider Demographics
NPI:1295856987
Name:LEEY-CASELLA, JULIO ALBERTO (MD)
Entity Type:Individual
Prefix:MR
First Name:JULIO
Middle Name:ALBERTO
Last Name:LEEY-CASELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1600 SW ARCHER RD.
Mailing Address - Street 2:BOX 100226
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0226
Mailing Address - Country:US
Mailing Address - Phone:352-273-8662
Mailing Address - Fax:352-273-7441
Practice Address - Street 1:1600 SW ARCHER RD.
Practice Address - Street 2:BOX 100226
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0226
Practice Address - Country:US
Practice Address - Phone:352-273-8662
Practice Address - Fax:352-273-7441
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2016-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2008013467207R00000X
KYIP832207R00000X
IL036.124395207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016968500Medicaid
FLIN274ZMedicare PIN