Provider Demographics
NPI:1023898517
Name:ROJAS GONZALEZ, LEONELA
Entity type:Individual
Prefix:
First Name:LEONELA
Middle Name:
Last Name:ROJAS GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11395 SW DISCOVERY WAY
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2571
Mailing Address - Country:US
Mailing Address - Phone:561-260-3914
Mailing Address - Fax:
Practice Address - Street 1:11395 SW DISCOVERY WAY
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-2571
Practice Address - Country:US
Practice Address - Phone:561-260-3914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty