Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME 100709 | FL |
Y | 111NI0900X | Internist | ME 100709 | FL |
NPI | 1003082645 |
---|---|
Provider Name | Dr. Luis Leon Alvarado |
First Address | Tampa, FL 33612-4745 |
Second Address | Tampa, FL 33612-4745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2008 |
Last Update Date | 31/01/2012 |