Provider Demographics
NPI:1952372880
Name:MAS DE LEON, YOLANDA (MD)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:MAS DE LEON
Suffix:
Gender:F
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:PO BOX 228
Mailing Address - Street 2:
Mailing Address - City:PUERTO REAL
Mailing Address - State:PR
Mailing Address - Zip Code:00740-0228
Mailing Address - Country:US
Mailing Address - Phone:787-863-4886
Mailing Address - Fax:787-860-5144
Practice Address - Street 1:10 CALLE UNION
Practice Address - Street 2:FAJARDO MEDICAL PLAZA SUITE 103
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-4935
Practice Address - Country:US
Practice Address - Phone:787-863-4886
Practice Address - Fax:787-860-5144
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6491207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC78217Medicare UPIN
PR97988Medicare ID - Type Unspecified