Organization
LEESBURG PSYCHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVELYN R. BAEZ-ROJAS PH.D. (OWNER)
(352) 787-7144
Entity
Organization
Contact information
Practice address
8529 US HIGHWAY 441, LEESBURG, FL 34788-4021
(352) 787-7144
(352) 450-7600
Mailing address
8529 US HIGHWAY 441, LEESBURG, FL 34788-4021
(352) 787-7144
(352) 450-7600
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY4794
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59515
BLUE CROSS AND BLUE SHIELD OF FLORIDA
FL
Enumeration date
04/23/2010
Last updated
05/10/2010
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