Provider Demographics
NPI:1740574136
Name:LEON, ALEJANDRO A (MS, RD)
Entity Type:Individual
Prefix:MR
First Name:ALEJANDRO
Middle Name:A
Last Name:LEON
Suffix:
Gender:M
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3102 COMMERCE PKWY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3943
Mailing Address - Country:US
Mailing Address - Phone:305-816-5800
Mailing Address - Fax:305-816-5844
Practice Address - Street 1:3102 COMMERCE PARKWAY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025
Practice Address - Country:US
Practice Address - Phone:305-816-5800
Practice Address - Fax:305-816-5844
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 5725133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered