Provider Demographics
NPI:1487415162
Name:BELTRAN LEIROS, SAYULI
Entity type:Individual
Prefix:
First Name:SAYULI
Middle Name:
Last Name:BELTRAN LEIROS
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 1:1871 PALM ACRES DR APT N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6522
Mailing Address - Country:US
Mailing Address - Phone:561-294-3394
Mailing Address - Fax:
Practice Address - Street 1:1871 PALM ACRES DR APT N
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6522
Practice Address - Country:US
Practice Address - Phone:561-294-3394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-19
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-313115106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician