Provider Demographics
NPI:1578395695
Name:LESTON, ASIEL
Entity type:Individual
Prefix:
First Name:ASIEL
Middle Name:
Last Name:LESTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9987 SW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1858
Mailing Address - Country:US
Mailing Address - Phone:561-608-3573
Mailing Address - Fax:305-703-4970
Practice Address - Street 1:9987 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1858
Practice Address - Country:US
Practice Address - Phone:561-608-3573
Practice Address - Fax:305-703-4970
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician