Provider Demographics
NPI:1790654788
Name:ROJAS, LEONARDO JONATHAN
Entity type:Individual
Prefix:
First Name:LEONARDO
Middle Name:JONATHAN
Last Name:ROJAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N LINCOLN AVE APT 115
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:NE
Mailing Address - Zip Code:68467-3563
Mailing Address - Country:US
Mailing Address - Phone:309-379-5911
Mailing Address - Fax:309-379-5911
Practice Address - Street 1:2208 N WEBB RD UNIT 4
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-1756
Practice Address - Country:US
Practice Address - Phone:308-381-1690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-30
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant