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Individual

DR. LEILA M PATALLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1350 HICKORY ST, MELBOURNE, FL 32901
(321) 434-1771
(321) 434-1775
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME84982
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
126747500
FL
01
134295171
TRICARE SOUTH GROUP #
FL
01
134295178
HEALTH FIRST
FL
01
13868
BLUE CROSS BLUE SHIELD
FL
01
3098980
GHI
FL
01
3956438
AETNA GROUP NUMBER
FL
01
7735972
CIGNA
FL
01
7835391
AETNA PROVIDER NUMBER
FL
01
DD8925
PALMETTO GBA GROUP #
FL
01
P01361854
HF RR MEDICARE
FL
Enumeration date
07/11/2006
Last updated
05/21/2025
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