MEDICARE: LEONARDO GABRIEL NEGRON ROCHE BSN, RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WS0200X	School Registered Nurse	84366	PR
2	163W00000X	Registered Nurse	RN9695878	FL
3	163W00000X	Registered Nurse	867588	NY
4	163W00000X	Registered Nurse	84366	PR

General Provider Information

NPI Number	:	1124897764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEONARDO GABRIEL NEGRON ROCHE BSN, RN

Provider Business Mailing Address
First Line	:	PO BOX 941
Second Line	:
City	:	ISABELA
State	:	PR
Zip	:	00662-0941
Country	:	US
Telephone Number	:	939-339-0016
Fax Number	:

Provider Business Practice Location Address
First Line	:	232 CALLE COQUI
Second Line	:
City	:	ISABELA
State	:	PR
Zip	:	00662-2138
Country	:	US
Telephone Number	:	939-339-0016
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2023
Last Update Date	:	05/11/2026

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