Provider Demographics
NPI:1376397356
Name:GONZALEZ PASCUAL, ELDA MARGARITA (RBT)
Entity Type:Individual
Prefix:
First Name:ELDA
Middle Name:MARGARITA
Last Name:GONZALEZ PASCUAL
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:ELDA
Other - Middle Name:MARGARTIA
Other - Last Name:GONZALEZ PASCUAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:2693 MORES RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7714
Mailing Address - Country:US
Mailing Address - Phone:561-410-6996
Mailing Address - Fax:
Practice Address - Street 1:2693 MORES RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-7714
Practice Address - Country:US
Practice Address - Phone:561-410-6996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty