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Individual

JORGE J LEAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
825 N COURTENAY PKWY, MERRITT ISLAND, FL 32953-4652
(321) 452-2563
(321) 453-5841
Mailing address
825 N COURTENAY PKWY, MERRITT ISLAND, FL 32953-4652
(321) 452-2563
(321) 453-5841

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME29037
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05400
BLUE CROSS BLUE SHIELD
FL
01
1653673
CIGNA
01
406142183
RAIL ROAD MEDICARE
01
4104040
AETNA
Enumeration date
02/20/2007
Last updated
07/08/2010
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