Basic Information
| Provider Information | |||||||||
| NPI: | 1215282553 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GONZALEZ | ||||||||
| FirstName: | BEATRIZ | ||||||||
| MiddleName: | MARGARITA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 411 W 28TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331404307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3053238236 | ||||||||
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| Practice Location | |||||||||
| Address1: | 13195 SW 134TH ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331864585 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7862066500 | ||||||||
| FaxNumber: | 3058469711 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2012 | ||||||||
| LastUpdateDate: | 06/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.