MEDICARE: LAURA VERONICA LEON PRIMO RBT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		FL

General Provider Information

NPI Number	:	1356276091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA VERONICA LEON PRIMO RBT

Provider Business Mailing Address
First Line	:	11901 SW 180TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-2414
Country	:	US
Telephone Number	:	305-890-0099
Fax Number	:

Provider Business Practice Location Address
First Line	:	11901 SW 180TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-2414
Country	:	US
Telephone Number	:	305-890-0099
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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Directions to “ LAURA VERONICA LEON PRIMO RBT” Practice Location

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