Provider Demographics
NPI:1568354009
Name:REYES LEIVA, ROBERTO ARTURO (BCBA)
Entity type:Individual
Prefix:
First Name:ROBERTO
Middle Name:ARTURO
Last Name:REYES LEIVA
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 W 46TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3947
Mailing Address - Country:US
Mailing Address - Phone:786-744-0828
Mailing Address - Fax:
Practice Address - Street 1:704 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-6012
Practice Address - Country:US
Practice Address - Phone:305-481-2198
Practice Address - Fax:305-402-8251
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12582642OtherBCBA