De Leon Reyes, Pedro Josue

De Leon Reyes, Pedro Josue is an sole proprietor health care provider with primary practice located at 619 S Marion Ave , Lake City FL 32025-5808. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. De Leon Reyes, Pedro Josue can be contacted via phone (386) 755-3016.

Contact Information

Primary practice address
619 S Marion Ave Lake City FL 32025-5808
Phone: (386) 755-3016
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 17332 Puerto Rico
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X ACN518 Florida

Profile Details

NPI number 1518117035
LBN Legal business name De Leon Reyes, Pedro Josue
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 19th, 2008
Last updated Oct 21st, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518117035 NPPES
Puerto Rico Other 17332 STATE LICENSE

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