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Individual

DR. KEILA THAMAR TOSADO DE LEON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
4729 US HIGHWAY 98 S STE 201, LAKELAND, FL 33812-4336
(863) 646-9663
(863) 646-9664
Mailing address
6675 WESTWOOD BLVD STE 475, ORLANDO, FL 32821-6027
(407) 845-0330
(888) 972-1752

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ACN483
FL
208D00000X
General Practice Physician
17316
PR
208D00000X
General Practice Physician
Primary
ACN483
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ACN483
MEDICINE DOCTOR LIC
FL
Enumeration date
09/15/2008
Last updated
06/02/2023
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