Provider Demographics
NPI:1619555414
Name:LEYVA, NELVIS (RBT)
Entity Type:Individual
Prefix:
First Name:NELVIS
Middle Name:
Last Name:LEYVA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 NW 181ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4228
Mailing Address - Country:US
Mailing Address - Phone:786-597-1513
Mailing Address - Fax:
Practice Address - Street 1:12905 BIRD RD STE 111
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-2910
Practice Address - Country:US
Practice Address - Phone:786-558-4091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician