=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861087751
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | B DE LEON BEHAVIOR MENTAL HELTH SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2021
-----------------------------------------------------
Last Update Date | 11/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8900 SW 117TH AVE STE C101
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33186-2184
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-740-1229
-----------------------------------------------------
Fax | 786-866-6337
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16142 SW 73RD ST
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33193-2947
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-740-1229
-----------------------------------------------------
Fax | 786-866-6337
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MS BCBA
-----------------------------------------------------
Name | BEATRIZ MARTINEZ
-----------------------------------------------------
Credential | BCBA
-----------------------------------------------------
Telephone | 786-740-1229
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171W00000X
-----------------------------------------------------
Taxonomy Name | Contractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------