Individual
LEONARDO JOSE DIAZ GANDICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2100 STANTONSBURG RD, GREENVILLE, NC 27834-2818
(252) 744-5291
(252) 744-0013
Mailing address
105 W VICTORIA CT APT A, GREENVILLE, NC 27834-7639
(314) 489-7402
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
RTL25-1042
NC
Other
Enumeration date
06/17/2024
Last updated
07/07/2025
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