Provider Demographics
NPI:1639898927
Name:SANCHEZ HENANDEZ, LEYDI
Entity Type:Individual
Prefix:
First Name:LEYDI
Middle Name:
Last Name:SANCHEZ HENANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 SW 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5265
Mailing Address - Country:US
Mailing Address - Phone:786-353-2900
Mailing Address - Fax:786-364-1676
Practice Address - Street 1:16210 SW 98TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-3361
Practice Address - Country:US
Practice Address - Phone:786-355-5106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT-22-219975Medicaid