Individual
CAMILO LEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 HERRELL RD, VILLA RICA, GA 30180
(770) 812-3530
Mailing address
20 HERRELL RD, VILLA RICA, GA 30180-5527
(770) 812-3530
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
83459
GA
2084P0800X
Psychiatry Physician
ME133544
FL
Other
Enumeration date
05/14/2014
Last updated
07/09/2019
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