Provider Demographics
NPI:1326893751
Name:CUETO GONZALEZ, ROSANGELA
Entity Type:Individual
Prefix:
First Name:ROSANGELA
Middle Name:
Last Name:CUETO 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 1:11826 HULLBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-5727
Mailing Address - Country:US
Mailing Address - Phone:727-358-3587
Mailing Address - Fax:
Practice Address - Street 1:11826 HULLBRIDGE CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-5727
Practice Address - Country:US
Practice Address - Phone:727-358-3587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-337525106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician