Provider Demographics
NPI:1699538512
Name:NIEVES ROSA, LEENOSHKA T
Entity type:Individual
Prefix:
First Name:LEENOSHKA
Middle Name:T
Last Name:NIEVES ROSA
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 1:602 CRANE DR
Mailing Address - Street 2:
Mailing Address - City:POINCIANA
Mailing Address - State:FL
Mailing Address - Zip Code:34759-4530
Mailing Address - Country:US
Mailing Address - Phone:787-940-1765
Mailing Address - Fax:
Practice Address - Street 1:602 CRANE DR
Practice Address - Street 2:
Practice Address - City:POINCIANA
Practice Address - State:FL
Practice Address - Zip Code:34759-4530
Practice Address - Country:US
Practice Address - Phone:787-940-1765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula