MEDICARE: TALIA GARCIA LEON

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1609633544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TALIA GARCIA LEON

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2520 CORAL WAY
Second Line	:	SUITE 2-19
City	:	MIAMI
State	:	FL
Zip	:	33145-3438
Country	:	US
Telephone Number	:	305-508-5580
Fax Number	:

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

Provider Enumeration Date	:	03/05/2024
Last Update Date	:	06/19/2026

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Directions to “ TALIA GARCIA LEON ” Practice Location

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