=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467302455
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LEANDRO PEREZ
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2026
-----------------------------------------------------
Last Update Date | 01/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9020 SW 137TH AVE STE 214
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33186-1427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-334-6991
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 260 NW 63RD AVE
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33126-4530
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-334-6991
-----------------------------------------------------
Fax | 786-334-6996
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number | RBT25487145
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------