MEDICARE: GABRIELLE LEON BS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	106S00000X	Behavior Technician
2	251B00000X	Case Management Agency
3	171M00000X	Case Manager/Care Coordinator

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417352139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLE LEON BS

Provider Business Mailing Address
First Line	:	700 S ROYAL POINCIANA BLVD STE 300
Second Line	:
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-6667
Country	:	US
Telephone Number	:	305-668-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 S ROYAL POINCIANA BLVD STE 300
Second Line	:
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-6667
Country	:	US
Telephone Number	:	305-668-9000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2014
Last Update Date	:	07/21/2022

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