| NPI | 1982290714 |
|---|---|
| Doing Business As | LEO CLINIC |
| Entity Type | Organization |
| Authorized Contact | CARLOS MARRERO Clinic Director 860-249-0975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 207QA0000X Family Medicine, Adolescent Medicine | |
| 207QA0505X Family Medicine, Adult Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2021-02-24 |