Healthcare Provider Details

I. General information

NPI: 1720825847
Provider Name (Legal Business Name): LESLIE N GARCIA RN, BSN.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

B7 CALLE SANTA CRUZ
BAYAMON PR
00961-6902
US

IV. Provider business mailing address

B7 CALLE SANTA CRUZ
BAYAMON PR
00961-6902
US

V. Phone/Fax

Practice location:
  • Phone: 787-780-9316
  • Fax: 787-778-2281
Mailing address:
  • Phone: 787-780-9316
  • Fax: 787-778-2281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number102796
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: