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General NPI Number Information
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NPI Number | 1093322760
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Entity Type | Individual
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Provider Name | GISELLE LEAL PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/28/2020
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 175 SW 7TH ST STE 2417
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City | MIAMI
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State | FL
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Zip | 33130-2966
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Country | US
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Telephone | 786-565-8006
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Fax |
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Provider Business Mailing Address
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Address Line | 175 SW 7TH ST STE 2417
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City | MIAMI
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State | FL
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Zip | 33130-2966
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PY10894
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | PY10894
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | PY10894
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY10894
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License Number State | FL
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