Provider Demographics
NPI:1326812694
Name:GONZALEZ REY, IVON I (RBT-23-292704)
Entity Type:Individual
Prefix:
First Name:IVON
Middle Name:
Last Name:GONZALEZ REY
Suffix:I
Gender:F
Credentials:RBT-23-292704
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9050 PINES BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6415
Mailing Address - Country:US
Mailing Address - Phone:954-744-4182
Mailing Address - Fax:954-842-2913
Practice Address - Street 1:9050 PINES BLVD STE 205
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6415
Practice Address - Country:US
Practice Address - Phone:954-744-4182
Practice Address - Fax:954-842-2913
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-292704106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician