Organization
PHY-MED MILLENIUM MEDICAL LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUSTAVO G LEON M.D. (MEDICAL DIRECTOR)
(305) 642-1246
Entity
Organization
Contact information
Practice address
351 NW 42ND AVE, SUITE 103, MIAMI, FL 33126-5683
(305) 642-1246
(305) 631-1419
Mailing address
7100 PINES BLVD, SUITE 23, PEMBROKE PINES, FL 33024-7355
(954) 967-0107
(954) 967-0109
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME 29633
FL
Other
Enumeration date
06/10/2006
Last updated
07/11/2007
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