Provider Demographics
NPI:1558039321
Name:ARCIA LEAL, DANIELA
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:ARCIA LEAL
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 1:5767 NW 151ST ST STE B
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2483
Mailing Address - Country:US
Mailing Address - Phone:786-431-5801
Mailing Address - Fax:
Practice Address - Street 1:6851 SW 129TH AVE APT 6
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-2457
Practice Address - Country:US
Practice Address - Phone:786-230-0362
Practice Address - Fax:866-500-2186
Is Sole Proprietor?:No
Enumeration Date:2021-09-05
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
FL1-24-73088103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician