Provider Demographics
NPI:1700765807
Name:VARELA DIAZ DE ACEVED, LEAH DE LA CARIDAD
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:DE LA CARIDAD
Last Name:VARELA DIAZ DE ACEVED
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 1:1335 NE 204TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-5156
Mailing Address - Country:US
Mailing Address - Phone:305-610-5683
Mailing Address - Fax:
Practice Address - Street 1:1335 NE 204TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-5156
Practice Address - Country:US
Practice Address - Phone:305-610-5683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-461085106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician