Healthcare Provider Details

I. General information

NPI: 1497682124
Provider Name (Legal Business Name): JASHIANET ROLDAN DE LEON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 CARR 844 CONDOMINIO ALTURAS DEL BOSQUE APT 1101
SAN JUAN PR
00926-7860
US

IV. Provider business mailing address

350 CARR 844 CONDOMINIO ALTURAS DEL BOSQUE APT.1101
SAN JUAN PR
00926-7860
US

V. Phone/Fax

Practice location:
  • Phone: 787-341-2652
  • Fax:
Mailing address:
  • Phone: 787-341-2652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6262
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: