Provider Demographics
NPI:1871210880
Name:ACOSTA BARZAGA, LEYANIS
Entity type:Individual
Prefix:
First Name:LEYANIS
Middle Name:
Last Name:ACOSTA BARZAGA
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 1:15900 SW 104TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1573
Mailing Address - Country:US
Mailing Address - Phone:305-846-1312
Mailing Address - Fax:
Practice Address - Street 1:7990 SW 117TH AVE STE 125
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-3845
Practice Address - Country:US
Practice Address - Phone:305-929-8705
Practice Address - Fax:305-600-3713
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-21
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker