Most Relevant Information
Provider Data
| NPI Number: | 1003589045 |
| Provider Name: | MAGALIS TAINELY LEON JORGE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-20-137159 |
Most Important Dates
| Enumeration Date: | 07/27/2021 |
| Last Updated: | 08/10/2021 |
Provider Practice Location
4421 NW 191ST ST
MIAMI GARDENS
FL
330552113
Practice Location Phone/Fax
| Phone: | 7867120186 |
| Fax: |
Provider Mailing Location
4421 NW 191ST ST
MIAMI GARDENS
FL
330552113
Provider Mailing Phone/Fax
| Phone: | 7867120186 |
| Fax: |