Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ivan Alexis Licea Tamayo, MD

Individual provider Family Medicine Physician · NPI 1669895223

Ivan Alexis Licea Tamayo, MD is a Family Practice in Montgomery, Alabama. Qualified in 1988, 38 years ago. Practices with Leon Medical Centers LLC, a 106-clinician group and accepts Medicare assignment. Licensed in Alabama and Florida.

Years since qualifying
38
Licensed in
AL, FL
In the registry since
2014
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4371 Narrow Lane Rd
Montgomery, AL 36116-2971
Phone: (334) 613-3680
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence L3510R (AL)
Family Medicine Physician Taxonomy 207Q00000X · Licence ME 118521 (FL)

Record details

NPI number1669895223
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 31, 2014
Last updated in NPPESJanuary 31, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1988 (38 years in practice)
Group practice Leon Medical Centers Llc — 106 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Montgomery