Healthcare Provider Details

I. General information

NPI: 1457032823
Provider Name (Legal Business Name): LICET DE LA CARIDAD LEON CABRERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2023
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 WINGED FOOT RD
PALM SPRINGS FL
33461-1826
US

IV. Provider business mailing address

329 WINGED FOOT RD
PALM SPRINGS FL
33461-1826
US

V. Phone/Fax

Practice location:
  • Phone: 561-772-0731
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-88518
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-283914
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: