Individual
DR. CARLOS A LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 PARK AVENUE, SUITE 101-B, ORANGE PARK, FL 32073-5072
(904) 264-0088
(904) 264-0099
Mailing address
2300 PARK AVENUE, SUITE 101-B, ORANGE PARK, FL 32073-5072
(904) 264-0088
(904) 264-0099
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
023844
GA
207RC0000X
Cardiovascular Disease Physician
Primary
ME56274
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00424135A
—
GA
05
—
00424135C
—
GA
05
—
062517500
—
FL
01
—
08605
BCBS
FL
01
—
100724
AVMED
FL
01
—
2006421
AETNA
FL
01
—
814095
BCBS
GA
Enumeration date
05/23/2005
Last updated
05/28/2014
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