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General NPI Number Information
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NPI Number | 1992546022
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Entity Type | Individual
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Provider Name | KEVIN RENAN LEYVA BARREDA
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Gender | Male
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 6900 S ORANGE BLOSSOM TRL
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City | ORLANDO
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State | FL
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Zip | 32809-5745
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Country | US
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Telephone | 407-602-7442
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Fax | 786-631-4483
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Provider Business Mailing Address
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Address Line | 765 HUMMINGBIRD LN
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City | ORLANDO
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State | FL
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Zip | 32825-7830
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Country | US
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Telephone | 786-644-8693
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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 | FL
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