Provider Demographics
NPI:1730182833
Name:DE LEON, SYLVETTE (MD)
Entity type:Individual
Prefix:MRS
First Name:SYLVETTE
Middle Name:
Last Name:DE LEON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:D27 AVE CRISALIDA
Mailing Address - Street 2:URB TORREMOLINOS
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3619
Mailing Address - Country:US
Mailing Address - Phone:787-751-3845
Mailing Address - Fax:787-751-3845
Practice Address - Street 1:CENTRO COMERCIAL RIO PIEDRAS HEIGHTS
Practice Address - Street 2:CALLE PARANA 1689 OFIC #5
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-751-3845
Practice Address - Fax:787-751-3845
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8193208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF-52864Medicare UPIN
PR0029579Medicare ID - Type Unspecified