Provider Demographics
NPI:1063021913
Name:LEYVA ARCEO, ERNESTO ALEJANDRO (RBT)
Entity Type:Individual
Prefix:MR
First Name:ERNESTO
Middle Name:ALEJANDRO
Last Name:LEYVA ARCEO
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 W 10TH AVE APT 301
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5178
Mailing Address - Country:US
Mailing Address - Phone:786-333-2037
Mailing Address - Fax:
Practice Address - Street 1:3555 W 10TH AVE APT 301
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5178
Practice Address - Country:US
Practice Address - Phone:786-333-2037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty