Healthcare Provider Details

I. General information

NPI: 1023614179
Provider Name (Legal Business Name): LEOPOLDO ANDARA LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 SW 74TH ST STE 408
SOUTH MIAMI FL
33143-5164
US

IV. Provider business mailing address

7261 SHERIDAN ST STE 340
HOLLYWOOD FL
33024-2726
US

V. Phone/Fax

Practice location:
  • Phone: 305-735-3555
  • Fax: 954-990-7650
Mailing address:
  • Phone: 954-561-6222
  • Fax: 954-990-7650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH22155
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: