Provider Demographics
NPI:1407930449
Name:CUMENAL, LESLIE DIAMOND (OTR, CHT)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:DIAMOND
Last Name:CUMENAL
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6917 COLLINS AVE APT 715
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-7206
Mailing Address - Country:US
Mailing Address - Phone:646-522-2638
Mailing Address - Fax:212-604-1320
Practice Address - Street 1:6917 COLLINS AVE APT 715
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-7206
Practice Address - Country:US
Practice Address - Phone:646-522-2638
Practice Address - Fax:212-604-1320
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010596225XH1200X
NY010596-1225XH1200X
FLOT22358225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQU560QAQX1Medicare PIN
CTD400023187Medicare PIN