Healthcare Provider Details

I. General information

NPI: 1104605336
Provider Name (Legal Business Name): LESYANY CARIDAD LUYA LLERENA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13550 SW 88TH ST STE 294
MIAMI FL
33186-1513
US

IV. Provider business mailing address

351 E DAVIS PKWY APT 201
FLORIDA CITY FL
33034-3761
US

V. Phone/Fax

Practice location:
  • Phone: 786-909-0622
  • Fax:
Mailing address:
  • Phone: 786-909-0622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2844609
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: