Healthcare Provider Details

I. General information

NPI: 1477967180
Provider Name (Legal Business Name): LETICIA BONACHEA MS SPECIAL EDUCATION
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2014
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2796 W 55TH PL
HIALEAH FL
33016-4054
US

IV. Provider business mailing address

2796 W 55TH PL
HIALEAH FL
33016-4054
US

V. Phone/Fax

Practice location:
  • Phone: 305-244-2620
  • Fax:
Mailing address:
  • Phone: 305-244-2620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-56295
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: