Provider Demographics
NPI:1124897764
Name:NEGRON ROCHE, LEONARDO GABRIEL (BSN, RN, EMT-P)
Entity type:Individual
Prefix:
First Name:LEONARDO
Middle Name:GABRIEL
Last Name:NEGRON ROCHE
Suffix:
Gender:
Credentials:BSN, RN, EMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 941
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-0941
Mailing Address - Country:US
Mailing Address - Phone:939-339-0016
Mailing Address - Fax:
Practice Address - Street 1:232 CALLE COQUI
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-2138
Practice Address - Country:US
Practice Address - Phone:939-339-0016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-22
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3407146L00000X
PR84366163W00000X, 163WS0200X
NY867588171000000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No163WS0200XNursing Service ProvidersRegistered NurseSchool
No171000000XOther Service ProvidersMilitary Health Care Provider