Provider Demographics
NPI:1891991352
Name:PIRILLO, LEONARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARDO
Middle Name:
Last Name:PIRILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LEONARDO
Other - Middle Name:
Other - Last Name:PIRILLO-FAVOT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1713 CALLE GERANIO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6336
Mailing Address - Country:US
Mailing Address - Phone:787-310-0137
Mailing Address - Fax:
Practice Address - Street 1:AVE EUGENIO ASTOL
Practice Address - Street 2:BAIROA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-744-4343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101256889208100000X
GA73791208100000X
PR172642081S0010X, 2085U0001X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound