Provider Demographics
NPI:1295185379
Name:LEON, ADRIAN (RBT)
Entity Type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:
Last Name:LEON
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 1:275 FONTAINEBLEAU BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4500
Mailing Address - Country:US
Mailing Address - Phone:305-551-3003
Mailing Address - Fax:
Practice Address - Street 1:275 FONTAINEBLEAU BLVD STE 120
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4500
Practice Address - Country:US
Practice Address - Phone:305-551-3003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health