Provider Demographics
NPI:1245716158
Name:DE LEON, JIZZEL ANNE VELASCO (DNP)
Entity type:Individual
Prefix:
First Name:JIZZEL ANNE
Middle Name:VELASCO
Last Name:DE LEON
Suffix:
Gender:F
Credentials:DNP
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Other - Middle Name:
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Mailing Address - Street 1:4012 SAWYER RD STE 101-104
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1231
Mailing Address - Country:US
Mailing Address - Phone:941-893-2688
Mailing Address - Fax:
Practice Address - Street 1:4012 SAWYER RD STE 101-104
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1231
Practice Address - Country:US
Practice Address - Phone:941-893-2688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL9345551363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner