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General NPI Number Information
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NPI Number | 1720644016
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Entity Type | Individual
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Provider Name | LEONARDO CHICO PIMENTEL BEHAVIOR ANALYST
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Gender | Male
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 9044 SW 153RD CT
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City | MIAMI
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State | FL
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Zip | 33196-2932
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Country | US
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Telephone | 786-817-5140
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Fax |
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Provider Business Mailing Address
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Address Line | 11174 SW 71ST LN
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City | MIAMI
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State | FL
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Zip | 33173-2115
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Country | US
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Telephone | 786-817-5140
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-22-13747
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-18-67052
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BCBA1-23-64511
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License Number State | FL
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