Individual
JORGE LUIS PENALVER LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 243-7067
Mailing address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD464582
PA
207RC0000X
Cardiovascular Disease Physician
Primary
ME157432
FL
390200000X
Student in an Organized Health Care Education/Training Program
MT209582
PA
390200000X
Student in an Organized Health Care Education/Training Program
TRN25839
FL
Other
Enumeration date
06/22/2015
Last updated
07/12/2022
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