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NPI 1619555414

NPI 1619555414 : NELVIS LEYVA RBT : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1619555414
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    Entity Type          |    Individual 
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    Provider Name        |    NELVIS LEYVA RBT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/01/2021
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    Last Update Date     |    04/01/2021
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Provider Practice Location Address
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    Address Line         |    12905 BIRD RD STE 111 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33175-2910
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    Country              |    US
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    Telephone            |    786-558-4091
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1001 NW 181ST ST 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33169-4228
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    Country              |    US
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    Telephone            |    786-597-1513
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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        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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