Ernest de Leon, MD, PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

0061518 Issued in FL

Legal business name

ERNEST DE LEON, MD, PA

Practice address

4225 NW American LN
Lake City, FL 32055-4881

Phone

(386) 758-6141

NPI assigned

May 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ernest Paul De Leon, MD

Title

Owner

Phone

(386) 758-6141

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114149234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 NW AMERICAN LN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554881",
            "telephone_number": "386-758-6141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 NW AMERICAN LN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554881",
            "telephone_number": "386-758-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERNEST DE LEON, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DE LEON",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-758-6141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "0061518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Lake City, FL
• Providers in Lake City, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.