Healthcare Provider Details

I. General information

NPI: 1902712581
Provider Name (Legal Business Name): LEUVIS PEREZ ROGENA RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 PONCE DE LEON BLVD
BROOKSVILLE FL
34601-1903
US

IV. Provider business mailing address

10020 SPRING HILL DR
SPRING HILL FL
34608-6471
US

V. Phone/Fax

Practice location:
  • Phone: 352-737-1183
  • Fax:
Mailing address:
  • Phone: 727-992-8105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-484232
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: