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Individual
DR. KETEVAN LEO
Active
Individual
DR. KETEVAN LEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME103381
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001168800
—
FL
01
—
P00765486
RAILROAD MEDICARE
FL
Enumeration date
03/06/2009
Last updated
09/10/2024
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