Provider Demographics
NPI:1225541980
Name:LEONOR, CAMILA PATRICIA
Entity Type:Individual
Prefix:
First Name:CAMILA
Middle Name:PATRICIA
Last Name:LEONOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 S DOUGLAS RD STE 230
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4108
Mailing Address - Country:US
Mailing Address - Phone:844-854-1116
Mailing Address - Fax:305-846-9711
Practice Address - Street 1:1160 S SEMORAN BLVD STE AB
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-1461
Practice Address - Country:US
Practice Address - Phone:305-846-9807
Practice Address - Fax:305-846-9711
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
FLRBT-18-47803106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst