Provider Demographics
NPI:1689194367
Name:GONZALEZ ALVAREZ, AINELY
Entity Type:Individual
Prefix:
First Name:AINELY
Middle Name:
Last Name:GONZALEZ ALVAREZ
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 1:6801 SW 79TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-2637
Mailing Address - Country:US
Mailing Address - Phone:786-344-3818
Mailing Address - Fax:
Practice Address - Street 1:4845 NW 189TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-2559
Practice Address - Country:US
Practice Address - Phone:786-344-3818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty