Individual
DR. NICOLO LEYEZA CABRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12634 OLIVE BLVD, DIV IM INFECTIOUS DISEASE, SAINT LOUIS, MO 63141-6337
(314) 996-8000
(314) 362-9851
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 996-8000
(314) 362-9851
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2021000356
MO
207RI0200X
Infectious Disease Physician
Primary
2021000356
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200098915
—
MO
Enumeration date
07/07/2014
Last updated
04/15/2025
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