Provider Demographics
NPI:1881119022
Name:GONZALEZ, LESLIE JOYCE
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:JOYCE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LESLIE
Other - Middle Name:JOYCE
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2540 KING OAK CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-6643
Mailing Address - Country:US
Mailing Address - Phone:407-777-1434
Mailing Address - Fax:407-593-8873
Practice Address - Street 1:2540 KING OAK CIR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-6643
Practice Address - Country:US
Practice Address - Phone:407-777-1434
Practice Address - Fax:407-593-8873
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program