Healthcare Provider Details

I. General information

NPI: 1790551448
Provider Name (Legal Business Name): NATALIE LEYVA LEYVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8595 SW 152ND AVE APT 254
MIAMI FL
33193-4115
US

IV. Provider business mailing address

8595 SW 152ND AVE APT 254
MIAMI FL
33193-4115
US

V. Phone/Fax

Practice location:
  • Phone: 786-356-2841
  • Fax:
Mailing address:
  • Phone: 786-356-2841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-25-16632
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: