Provider Demographics
NPI:1477268167
Name:CARDENAS GONZALEZ, LIBMARY
Entity Type:Individual
Prefix:
First Name:LIBMARY
Middle Name:
Last Name:CARDENAS 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 1:2086 46TH ST SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-5838
Mailing Address - Country:US
Mailing Address - Phone:239-238-9924
Mailing Address - Fax:
Practice Address - Street 1:2086 46TH ST SW
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-5838
Practice Address - Country:US
Practice Address - Phone:239-238-9924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-248789106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician