Healthcare Provider Details

I. General information

NPI: 1639898927
Provider Name (Legal Business Name): LEYDI SANCHEZ HENANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16210 SW 98TH CT
MIAMI FL
33157-3361
US

IV. Provider business mailing address

12700 SW 122ND AVE
MIAMI FL
33186-5265
US

V. Phone/Fax

Practice location:
  • Phone: 786-355-5106
  • Fax:
Mailing address:
  • Phone: 786-353-2900
  • Fax: 786-364-1676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: