Provider Demographics
NPI:1407281801
Name:LESLIE CARDENAS PSYD, P.A.
Entity Type:Organization
Organization Name:LESLIE CARDENAS PSYD, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDENAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:786-393-8840
Mailing Address - Street 1:3785 NW 82ND AVE
Mailing Address - Street 2:#307
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6655
Mailing Address - Country:US
Mailing Address - Phone:786-393-8840
Mailing Address - Fax:
Practice Address - Street 1:3785 NW 82ND AVE
Practice Address - Street 2:#307
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6655
Practice Address - Country:US
Practice Address - Phone:786-393-8840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 8471103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty