Individual
ERNEST PAUL DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4225 NW AMERICAN LN, LAKE CITY, FL 32055-8841
(386) 758-6141
Mailing address
4225 NW AMERICAN LN, LAKE CITY, FL 32055-8841
(386) 758-6141
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0061518
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370092500
—
FL
Enumeration date
10/02/2006
Last updated
02/10/2022
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