Provider Demographics
NPI:1760127831
Name:ROIG LEON, JIANIVEL
Entity Type:Individual
Prefix:
First Name:JIANIVEL
Middle Name:
Last Name:ROIG LEON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14606 SW 38TH ST APT 6
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-7852
Mailing Address - Country:US
Mailing Address - Phone:305-613-0211
Mailing Address - Fax:
Practice Address - Street 1:14606 SW 38TH ST APT 6
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-7852
Practice Address - Country:US
Practice Address - Phone:305-613-0211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician