Healthcare Provider Details
I. General information
NPI: 1598901712
Provider Name (Legal Business Name): LEANNE DENISE GONZALEZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/17/2008
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 E ROLLINS ST
ORLANDO FL
32803-1248
US
IV. Provider business mailing address
601 E ROLLINS ST
ORLANDO FL
32803-1248
US
V. Phone/Fax
- Phone: 407-303-2528
- Fax: 407-303-2760
- Phone: 407-303-2528
- Fax: 407-303-2760
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LN0000X |
| Taxonomy | Neonatal Nurse Practitioner |
| License Number | APRN11015734 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LN0000X |
| Taxonomy | Neonatal Nurse Practitioner |
| License Number | 5004211 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: