Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | ME135299 | FL |
NPI | 1699039123 |
---|---|
Provider Name | Dr. Carmen Elisa Leon Astudillo |
First Address | Gainesville, FL 32610-3003 |
Second Address | Gainesville, FL 32610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2012 |
Last Update Date | 07/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100114700 | (05) | FL |