# LESTER DE LEON MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164796090
- **Authorized official:** LESTER DE LEON MD (PRESIDENT)
- **Authorized official phone:** (786) 259-5449

## Contact information

- **Practice address:** 4155 SW 136TH AVE, MIAMI, FL 33175-3253
- **Practice address phone:** (786) 536-7614
- **Mailing address:** 4155 SW 136TH AVE, MIAMI, FL 33175-3253

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | ME111208 | FL | Yes |

## Other

- **Enumeration date:** 02/23/2012
- **Last updated:** 02/23/2012