Provider Demographics
NPI:1396214508
Name:GONZALEZ FIGUEROA, YANILA
Entity Type:Individual
Prefix:
First Name:YANILA
Middle Name:
Last Name:GONZALEZ FIGUEROA
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 1:6310 NW 63RD WAY
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-1518
Mailing Address - Country:US
Mailing Address - Phone:561-657-6562
Mailing Address - Fax:
Practice Address - Street 1:6310 NW 63RD WAY
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067-1518
Practice Address - Country:US
Practice Address - Phone:561-657-6562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-16
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-50409103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty