Provider Demographics
NPI:1205155835
Name:LEON, ALBERTO (MD)
Entity type:Individual
Prefix:DR
First Name:ALBERTO
Middle Name:
Last Name:LEON
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:CALLE ROSSY ESQUINA ISABEL II
Mailing Address - Street 2:EDIFICIO MONTESINO OFICINA 101
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:786-216-5302
Mailing Address - Fax:
Practice Address - Street 1:CALLE ROSSY ESQUINA ISABEL II
Practice Address - Street 2:EDIFICIO MONTESINO OFICINA 101
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:786-216-5302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17337208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice