Provider Demographics
NPI:1518137462
Name:CARDENAS, LESLIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8471103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical