Provider Demographics
NPI:1225805682
Name:GONZALEZ VIGOA, ARLET M
Entity Type:Individual
Prefix:
First Name:ARLET
Middle Name:M
Last Name:GONZALEZ VIGOA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6436 NARCOOSSEE RD APT 228
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-0006
Mailing Address - Country:US
Mailing Address - Phone:786-835-4036
Mailing Address - Fax:
Practice Address - Street 1:6436 NARCOOSSEE RD APT 228
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-0006
Practice Address - Country:US
Practice Address - Phone:786-835-4036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-305464106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician