Provider Demographics
NPI:1184156705
Name:ALVAREZ, LEONOR
Entity type:Individual
Prefix:
First Name:LEONOR
Middle Name:
Last Name:ALVAREZ
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 1:2430 DEER CREEK COUNTRY CLUB BLVD
Mailing Address - Street 2:T2-601
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1102
Mailing Address - Country:US
Mailing Address - Phone:954-598-5842
Mailing Address - Fax:
Practice Address - Street 1:5180 W ATLANTIC AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8103
Practice Address - Country:US
Practice Address - Phone:561-674-9996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-02
Last Update Date:2017-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician