Doctor Name: | BRIAN M LEO |
NPI Number: | 1376750265 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | ME98196 |
Business Practice Address: | 1150 Campo Sano Ave Suite 200 Coral Gables, FL - 331461174 |
Business Phone Number: | 3056693320 |
Business Fax Number: | 3056693324 |
Mailing Address: | 3399 Nw 72nd Ave, Suite 101 MIAMI |
State: | FL |
Postal Code: | 331221349 |
Phone Number: | 3056693320 |
Fax Number: | 3056693352 |
NPI Enumeration Date: | 05/17/2007 |
NPI Last Update Date: | 06/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | ME98196 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |