Most Relevant Information
Provider Data
| NPI Number: | 1003659269 |
| Provider Name: | LEONARDO J DIAZ GANDICA MD |
| Entity Type: | Individual |
| Taxonomy Code: | 208600000X |
| Specialty: | Surgery |
| License Number: | 2024017947 |
Most Important Dates
| Enumeration Date: | 06/17/2024 |
| Last Updated: | 06/17/2024 |
Provider Practice Location
510 S KINGSHIGHWAY BLVD
SAINT LOUIS
MO
631101016
Practice Location Phone/Fax
| Phone: | 3142862000 |
| Fax: |
Provider Mailing Location
3439 MAGNOLIA AVE
SAINT LOUIS
MO
631181140
Provider Mailing Phone/Fax
| Phone: | 3144897402 |
| Fax: |
Suggested EMR
Surgeon EMR