Provider Demographics
NPI:1023707726
Name:TEJERA LEON, BELKYS MARIA
Entity type:Individual
Prefix:
First Name:BELKYS
Middle Name:MARIA
Last Name:TEJERA LEON
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 1:4482 SW 164TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5283
Mailing Address - Country:US
Mailing Address - Phone:786-260-3164
Mailing Address - Fax:
Practice Address - Street 1:4482 SW 164TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5283
Practice Address - Country:US
Practice Address - Phone:786-260-3164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-122480106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician