Individual
DEOGENES G DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1115 E RIDGEWOOD ST, ORLANDO, FL 32803-5443
(407) 841-1100
Mailing address
PO BOX 809, GOSHEN, NY 10924-0809
(845) 294-8888
(845) 294-1669
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
228453
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
228453
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME154054
FL
207RP1001X
Pulmonary Disease Physician
Primary
228453
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02432997
—
NY
05
—
116843000
—
FL
01
—
P00378687
RAILROAD MEDICARE PIN
NY
Enumeration date
01/12/2006
Last updated
08/23/2024
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