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General NPI Number Information
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NPI Number | 1932999281
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Entity Type | Individual
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Provider Name | LEISY GONZALEZ FRONTELA
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Gender | Female
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 2010 NW 150TH AVE STE 201
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2888
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Country | US
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Telephone | 786-261-2139
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Fax |
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Provider Business Mailing Address
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Address Line | 1791 NW 96TH TER APT E
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3021
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Country | US
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Telephone | 305-322-4966
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-81059
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License Number State | FL
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