Provider Demographics
NPI:1457193625
Name:LEANES LEON, SOLIANET CARIDAD
Entity type:Individual
Prefix:
First Name:SOLIANET
Middle Name:CARIDAD
Last Name:LEANES 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 1:15950 SW 144TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-6886
Mailing Address - Country:US
Mailing Address - Phone:786-893-1752
Mailing Address - Fax:
Practice Address - Street 1:9020 SW 137TH AVE STE 214
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1427
Practice Address - Country:US
Practice Address - Phone:786-334-6991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-347845106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician