Healthcare Provider Details

I. General information

NPI: 1972605483
Provider Name (Legal Business Name): EDUARDO LEAL LMFT, PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2006
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 IVES DAIRY RD STE 228
MIAMI FL
33179-2538
US

IV. Provider business mailing address

1031 IVES DAIRY RD STE 228
MIAMI FL
33179-2538
US

V. Phone/Fax

Practice location:
  • Phone: 786-306-5534
  • Fax: 305-749-6369
Mailing address:
  • Phone: 786-306-5534
  • Fax: 305-749-6369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-59221
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY11342
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT 2528
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: