Individual
LEON ELLZY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
654 NE 9TH PL, HOMESTEAD, FL 33030-4934
(305) 248-3488
Mailing address
10477 SW 216TH ST, CUTLER BAY, FL 33190-1682
(305) 335-8439
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CBHCM100351
FLORIDA CERTIFICATION BOARD
FL
Enumeration date
03/16/2018
Last updated
06/16/2021
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