Healthcare Provider Details

I. General information

NPI: 1043740830
Provider Name (Legal Business Name): LEONARDO D GONZALEZ PARRILLA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2017
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 DOCTORS DR STE 2
HENDERSONVILLE NC
28792-7289
US

IV. Provider business mailing address

PO BOX 1869
FLETCHER NC
28732-1869
US

V. Phone/Fax

Practice location:
  • Phone: 828-650-2748
  • Fax:
Mailing address:
  • Phone:
  • Fax: 828-650-8076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number82688
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number202503721
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: