Provider Demographics
NPI:1558146787
Name:MURILLO CUARTAS, LEANDRO
Entity Type:Individual
Prefix:
First Name:LEANDRO
Middle Name:
Last Name:MURILLO CUARTAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NE 14TH AVE APT 224
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7408
Mailing Address - Country:US
Mailing Address - Phone:754-301-3270
Mailing Address - Fax:
Practice Address - Street 1:200 NE 14TH AVE APT 224
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-7408
Practice Address - Country:US
Practice Address - Phone:754-301-3270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health