Individual
MR. CARLOS A GONZALEZ ORTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
748 E 37TH ST, HIALEAH, FL 33013-2847
(786) 319-7603
Mailing address
748 E 37TH ST, HIALEAH, FL 33013-2847
(786) 319-7603
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-54657
FL
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
247200000X
Other Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017512900
—
FL
Enumeration date
05/20/2016
Last updated
11/03/2021
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