Individual
DR. MIGUEL A. DE LEON-BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
846 NE 54TH TERR, COLEMAN, FL 33521
(352) 689-7150
Mailing address
12817 SCOTTISH PINE LN, CLERMONT, FL 34711-7690
(352) 241-4646
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
3671
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3671
STATE LICENSE
PR
Enumeration date
06/26/2007
Last updated
07/08/2007
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