Individual
ADALYS MEDINA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3407 SW 116TH PL, MIAMI, FL 33165-3333
(786) 307-6939
Mailing address
3407 SW 116TH PL, MIAMI, FL 33165-3333
(786) 307-6939
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-82577
FL
Other
Enumeration date
05/01/2019
Last updated
05/01/2019
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