Provider Demographics
NPI:1316391105
Name:BORREGALES, LEONARDO DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:LEONARDO
Middle Name:DANIEL
Last Name:BORREGALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4302 ALTON RD STE 540
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2842
Mailing Address - Country:US
Mailing Address - Phone:305-674-2499
Mailing Address - Fax:305-674-2899
Practice Address - Street 1:4302 ALTON RD STE 540
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2842
Practice Address - Country:US
Practice Address - Phone:305-674-2499
Practice Address - Fax:305-674-2899
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME162501208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology