Provider Demographics
NPI:1396521290
Name:LEYVA FERRER, LINORGI
Entity type:Individual
Prefix:
First Name:LINORGI
Middle Name:
Last Name:LEYVA FERRER
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 1:2900 NW 21ST CT APT 202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-6098
Mailing Address - Country:US
Mailing Address - Phone:786-784-3717
Mailing Address - Fax:
Practice Address - Street 1:2900 NW 21ST CT APT 202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-6098
Practice Address - Country:US
Practice Address - Phone:786-784-3717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23289761106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty