Provider Demographics
NPI:1194567214
Name:LEYVA ABDALAHI, LEYLA SHAKIRA
Entity type:Individual
Prefix:
First Name:LEYLA
Middle Name:SHAKIRA
Last Name:LEYVA ABDALAHI
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 1:15321 SW 133RD PL APT 1003
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1172
Mailing Address - Country:US
Mailing Address - Phone:305-607-4383
Mailing Address - Fax:
Practice Address - Street 1:15321 SW 133RD PL APT 1003
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-1172
Practice Address - Country:US
Practice Address - Phone:305-607-4383
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-24-330362106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician