Provider Demographics
NPI:1750828224
Name:LEON MEDICAL RESEARCH
Entity Type:Organization
Organization Name:LEON MEDICAL RESEARCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANAIVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MELIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-823-4002
Mailing Address - Street 1:5931 NW 173RD DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5106
Mailing Address - Country:US
Mailing Address - Phone:305-823-4002
Mailing Address - Fax:305-823-4100
Practice Address - Street 1:5931 NW 173RD DR
Practice Address - Street 2:SUITE 7
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5106
Practice Address - Country:US
Practice Address - Phone:305-823-4002
Practice Address - Fax:305-823-4100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty