Provider Demographics
NPI:1720456023
Name:NIMER FIGUEROA, LEIDELYS
Entity Type:Individual
Prefix:
First Name:LEIDELYS
Middle Name:
Last Name:NIMER FIGUEROA
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 1:525 NW 27TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3039
Mailing Address - Country:US
Mailing Address - Phone:305-200-5073
Mailing Address - Fax:
Practice Address - Street 1:525 NW 27TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3039
Practice Address - Country:US
Practice Address - Phone:305-200-5073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103297900Medicaid