Provider Demographics
NPI:1659943165
Name:GONZALEZ ROJAS, FELIX A
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:A
Last Name:GONZALEZ ROJAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 E 23RD ST APT 1517
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3941
Mailing Address - Country:US
Mailing Address - Phone:786-720-9153
Mailing Address - Fax:
Practice Address - Street 1:440 E 23RD ST APT 1517
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3941
Practice Address - Country:US
Practice Address - Phone:786-720-9153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-164491106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician