Individual
MRS. ANA LOURDES GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4500 NW 107TH AVE APT 108, DORAL, FL 33178-1885
(786) 212-3689
Mailing address
4500 NW 107TH AVE APT 108, DORAL, FL 33178-1885
(786) 212-3689
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-217612
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RBT22-217612
—
FL
Enumeration date
12/20/2022
Last updated
12/20/2022
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