Provider Demographics
NPI:1386874071
Name:SPEISMAN, LEONARD (PHD)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:
Last Name:SPEISMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11417 SW 86TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4219
Mailing Address - Country:US
Mailing Address - Phone:305-271-7300
Mailing Address - Fax:
Practice Address - Street 1:11417 SW 86TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4219
Practice Address - Country:US
Practice Address - Phone:305-271-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY02813103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist