Individual
ALEXIS VARGAS LEIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17411 NW 47TH AVE, MIAMI GARDENS, FL 33055-3635
(786) 399-9151
Mailing address
17411 NW 47TH AVE, MIAMI GARDENS, FL 33055-3635
(786) 399-9151
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-115983
FL
Other
Enumeration date
05/25/2020
Last updated
05/25/2020
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