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Individual

MS. CHARISE MARIE LEON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1701 SW 16TH AVE BLDG B, GAINESVILLE, FL 32608-1153
(352) 294-8588
Mailing address
1701 SW 16TH AVE BLDG B, GAINESVILLE, FL 32608-1153
(352) 294-8588

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
690540496
FL
Enumeration date
09/14/2022
Last updated
09/14/2022
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