Provider Demographics
NPI:1891926911
Name:ESTRELLA, JOSE LEONARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:LEONARDO
Last Name:ESTRELLA
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 1:1475 W ORANGE BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-2828
Mailing Address - Country:US
Mailing Address - Phone:074-307-1041
Mailing Address - Fax:407-307-1039
Practice Address - Street 1:1475 W ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-2828
Practice Address - Country:US
Practice Address - Phone:407-307-1041
Practice Address - Fax:407-307-1039
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN978208D00000X
PR17661208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLACN978OtherFLORIDA BOARD OF MEDICINE
FLFE1727657OtherDEA