DR. PEDRO JOSUE DE LEON REYES (NPI# 1518117035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518117035 |
| Entity Type | Individual |
| Full Name | DR. PEDRO JOSUE DE LEON REYES |
| Credential | M.D. |
| Practice Address |
619 S Marion Ave Lake City FL 32025-5808 |
| Practice Telephone | 3867553016 |
| Mailing Telephone | 3867553016 |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2014-10-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | ACN518 | FL | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 17332 | PR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PR | STATE LICENSE | 17332 | 01 |
| Street Address |
619 S MARION AVE |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32025-5808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275520660 | Kay B Ramnarine | Counselor | 619 S Marion Ave, Lake City, FL 32025-5808 | 2005-09-30 |
| 1104442441 | Danielle Marie Howard | Student in an Organized Health Care Education/Training Program | 619 S Marion Ave, Lake City, FL 32025-5808 | 2020-06-23 |
| 1427672617 | James Wooley | Recreation Therapist | 619 S Marion Ave, Lake City, FL 32025-5808 | 2020-06-03 |
| 1316573611 | Tara S. Keen | Nurse Practitioner | 619 S Marion Ave, Lake City, FL 32025-5808 | 2020-03-18 |
| 1023653086 | Yen Margaret Dao Barnes | Pharmacist | 619 S Marion Ave, Lake City, FL 32025-5808 | 2019-11-14 |
| 1790328847 | Brittni Cleland | Dance Therapist | 619 S Marion Ave, Lake City, FL 32025-5808 | 2019-10-22 |
| 1801447800 | Warrenette Yvette Kelly | Social Worker | 619 S Marion Ave, Lake City, FL 32025-5808 | 2019-09-23 |
| 1982263117 | Katherine Susannah Mary Thomas | Optometrist | 619 S Marion Ave, Lake City, FL 32025-5808 | 2019-06-11 |
| 1952871220 | Michael Canard | Social Worker | 619 S Marion Ave, Lake City, FL 32025-5808 | 2018-11-29 |
| 1174009914 | Ashlyn Elizabeth Kerce | Pharmacist | 619 S Marion Ave, Lake City, FL 32025-5808 | 2018-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801438353 | Jennifer Bennett | Pharmacist | 347 Sw Main Blvd Suite 102, Lake City, FL 32025 | 2019-10-16 |
| 1700352838 | Robert J Sansouci IIi IIi | Physical Therapy Assistant | 560 Sw Mcfarlane Ave, Lake City, Fl, 32025, Lake City, FL 32025 | 2018-10-16 |
| 1316442783 | Emily Bailey | Developmental Therapist | 2126 Sw Sisters Welcome Rd, Lake City, FL 32025 | 2018-03-28 |
| 1811446370 | Michelle Hart | Behavioral Analyst | 260 S. Marion Avenue, Bldg. A, Suite 135, Lake City, FL 32025 | 2016-09-26 |
| 1922467646 | Irene Aponte Moreno | Nurse Practitioner | 440 Sw Perimeter Glen, Lake City, FL 32025 | 2016-02-23 |
| 1093186777 | Decarlos Scippio | Counselor | 619 Sw Baya Drive Suite 102, Lake City, FL 32025 | 2015-10-07 |
| 1497132476 | Jamecia Legree | Registered Nurse | 800 Sw Symphony Loop, Bldg 15 Apt 204, Lake City, FL 32025 | 2015-04-29 |
| 1306249149 | Mercy Home Assisted Living Facility LLC | Assisted Living Facility | 184 S.e. Beech Street, Lake City, FL 32025 | 2014-10-08 |
| 1598174344 | Karen Mcdonald | Developmental Therapist | 4523 Se County Road 252, Lake City, FL 32025 | 2014-08-06 |
| 1275944126 | Mohammad Ali Faisal Mdpa | Specialist | 1283 Sw State Rd 47, Ste 104, Lake City, FL 32025 | 2014-05-14 |
| Find all providers in zip 32025 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649836560 | Karimar Loumyr Sanchez | General Practice | 1037 W Us Highway 90 Ste 130, Lake City, FL 32055-3740 | 2019-05-16 |
| 1962835306 | Origins Family Medical & Weight Loss Clinic Inc | General Practice | 206 S Marion Ave, Lake City, FL 32025-7058 | 2013-08-20 |
| 1407062391 | Jose Raul Garriga-diaz I | General Practice | 7906 E Us Highway 90, Lake City, FL 32055-6290 | 2007-05-15 |
| 1790900447 | Leopold Bejamin Leblique | General Practice | 264 Sw Ridgeview Pl., Lake City, FL 32024 | 2007-04-16 |
| 1013061456 | Donald Brent Hayden | General Practice | 733 Sw State Road 47, Lake City, FL 32025-0453 | 2007-01-23 |
| 1093376139 | Complete Medical Group | General Practice | 444 Sw Alachua Ave, Lake City, FL 32025-5213 | 2019-06-27 |
| 1326373606 | Brent Hayden, M.d.,p.a. | General Practice | 733 Sw State Road 47, Lake City, FL 32025-0453 | 2009-10-05 |
| 1477791465 | Karymar Del Valle Serrano | General Practice | 619 S Marion Ave, Lake City, FL 32025-5808 | 2009-01-28 |
| 1043495427 | Advanced Medical Clinics, P.C. | General Practice | 5499 Jonesboro Rd, Lake City, GA 30260-3553 | 2008-01-04 |
| 1134186455 | Carolinas Medical Alliance Inc | General Practice | 101 John St, Lake City, SC 29560-2411 | 2006-04-28 |
| Find all providers in LAKE CITY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.