Healthcare Provider Details

I. General information

NPI: 1639813603
Provider Name (Legal Business Name): LEONTE ANIBAL ARIAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S DIXIE HWY STE 405
BOCA RATON FL
33432-7454
US

IV. Provider business mailing address

5862 W 2ND CT
HIALEAH FL
33012-2611
US

V. Phone/Fax

Practice location:
  • Phone: 786-278-5903
  • Fax: 561-734-1460
Mailing address:
  • Phone: 786-290-3522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-22-199880
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-71323
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: