Provider Demographics
NPI:1356427173
Name:LEON, DEBORAH (4774)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:LEON
Suffix:
Gender:F
Credentials:4774
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 JUAN H CINTRON
Mailing Address - Street 2:EXTANCIAS EL GOLF
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730
Mailing Address - Country:US
Mailing Address - Phone:787-840-8903
Mailing Address - Fax:787-840-8903
Practice Address - Street 1:334 CALLE JUAN H CINTRON
Practice Address - Street 2:EXTANCIAS EL GOLF
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-0515
Practice Address - Country:US
Practice Address - Phone:787-840-8903
Practice Address - Fax:787-840-8903
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR47741835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy