Provider Demographics
NPI:1124597406
Name:GONZALEZ, HAIDYS H (BA)
Entity Type:Individual
Prefix:MRS
First Name:HAIDYS
Middle Name:H
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2607 SUMMER WIND DR
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-5215
Mailing Address - Country:US
Mailing Address - Phone:407-773-4150
Mailing Address - Fax:
Practice Address - Street 1:1227 FLOWERS POINTE LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-5520
Practice Address - Country:US
Practice Address - Phone:407-620-0335
Practice Address - Fax:407-264-6482
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician