Provider Demographics
NPI:1871469718
Name:MORA, VALERIE LEILANI
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:LEILANI
Last Name:MORA
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 1:12530 SW 210TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-5765
Mailing Address - Country:US
Mailing Address - Phone:786-393-8592
Mailing Address - Fax:
Practice Address - Street 1:7355 SW 87TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3565
Practice Address - Country:US
Practice Address - Phone:305-854-2462
Practice Address - Fax:786-542-9754
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-16
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician