Provider Demographics
NPI:1275054439
Name:GONZALEZ, CLAUDIA
Entity Type:Individual
Prefix:MISS
First Name:CLAUDIA
Middle Name:
Last Name:GONZALEZ
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 1:333 S ROYAL POINCINA BLVD
Mailing Address - Street 2:APTO 303
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166
Mailing Address - Country:US
Mailing Address - Phone:786-805-2788
Mailing Address - Fax:786-805-2788
Practice Address - Street 1:333 S ROYAL POINCIANA BLVD APT 303
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-6173
Practice Address - Country:US
Practice Address - Phone:786-805-2788
Practice Address - Fax:786-805-2788
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAR30977Medicaid