Individual
DR. LEIDEN EZEQUIEL GONZALEZ PIMENTEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5425 S FLORIDA AVE, LAKELAND, FL 33813-2523
(863) 644-3585
(863) 644-3171
Mailing address
5425 S FLORIDA AVE, LAKELAND, FL 33813-2523
(863) 644-3585
(863) 644-3171
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
18095
PR
208D00000X
General Practice Physician
Primary
ACN688
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18095
PR LICENSE
PR
01
—
ACN688
MEDICAL LICENSE
FL
Enumeration date
11/26/2010
Last updated
10/05/2015
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