Provider Demographics
NPI:1962727651
Name:LEON, JAVIER ANTONIO (DC)
Entity type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:ANTONIO
Last Name:LEON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 CALLE VIEQUES
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1835
Mailing Address - Country:US
Mailing Address - Phone:787-667-2548
Mailing Address - Fax:
Practice Address - Street 1:404 CALLE LA RABIDA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3020
Practice Address - Country:US
Practice Address - Phone:787-771-9119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR478111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor