Provider Demographics
NPI:1487819256
Name:DE LEON, NANETTE MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:NANETTE
Middle Name:MICHELLE
Last Name:DE LEON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1803 CALLE DIAMELA
Mailing Address - Street 2:URB. SANTA MARIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6342
Mailing Address - Country:US
Mailing Address - Phone:787-764-4060
Mailing Address - Fax:
Practice Address - Street 1:SAN JUAN HEALTH CENTER SUITE 701
Practice Address - Street 2:150 AVE DE DIEGO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:939-545-8402
Practice Address - Fax:939-545-8439
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2022-10-18
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Provider Licenses
StateLicense IDTaxonomies
PR17637207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRHE716AMedicare PIN