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Organization
LEOCADIO B PENALOSA JR
Active
Organization
LEOCADIO B PENALOSA JR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEOCADIO B PENALOSA JR. MD (PHYSICIAN OWNER)
(757) 397-5301
Entity
Organization
Contact information
Practice address
301 GOODE WAY, STE 204, PORTSMOUTH, VA 23704
(757) 397-5301
(757) 397-9536
Mailing address
301 GOODE WAY, STE 204, PORTSMOUTH, VA 23704
(757) 397-5301
(757) 397-9536
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/28/2006
Last updated
06/17/2008
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