Provider Demographics
NPI:1164825642
Name:LEON, ENRIQUE (BCBA)
Entity type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:
Last Name:LEON
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 1:1555 KEY CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-2756
Mailing Address - Country:US
Mailing Address - Phone:407-267-2405
Mailing Address - Fax:
Practice Address - Street 1:2951 PARK POND WAY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7661
Practice Address - Country:US
Practice Address - Phone:321-355-3904
Practice Address - Fax:407-201-4782
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 106E00000X, 103K00000X
FL1-19-39692103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst