Provider Demographics
NPI:1265247191
Name:DEULOFEU DEULOFEU, LEONEL
Entity type:Individual
Prefix:
First Name:LEONEL
Middle Name:
Last Name:DEULOFEU DEULOFEU
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 1:7206 ANAQUITAS CREEK CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-7140
Mailing Address - Country:US
Mailing Address - Phone:786-804-1761
Mailing Address - Fax:
Practice Address - Street 1:8451 MANTA RAY CIR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-3228
Practice Address - Country:US
Practice Address - Phone:786-804-1761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19-82750106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician