Provider Demographics
NPI:1326635798
Name:ALVITE GONZALEZ, ELIDA (RBT)
Entity Type:Individual
Prefix:
First Name:ELIDA
Middle Name:
Last Name:ALVITE GONZALEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5449 TREVOR CIR APT 303
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-5221
Mailing Address - Country:US
Mailing Address - Phone:561-714-8751
Mailing Address - Fax:
Practice Address - Street 1:5449 TREVOR CIR APT 303
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-5221
Practice Address - Country:US
Practice Address - Phone:561-714-8751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-139092106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician