Provider Demographics
NPI:1821852682
Name:LEOMED137 INC
Entity Type:Organization
Organization Name:LEOMED137 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-631-3816
Mailing Address - Street 1:2450 SW 137TH AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6312
Mailing Address - Country:US
Mailing Address - Phone:786-631-3816
Mailing Address - Fax:
Practice Address - Street 1:2450 SW 137TH AVE STE 208
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6312
Practice Address - Country:US
Practice Address - Phone:786-631-3816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies