Provider Demographics
NPI:1710685458
Name:SAAVEDRA GONZALEZ, ANALIA
Entity Type:Individual
Prefix:
First Name:ANALIA
Middle Name:
Last Name:SAAVEDRA 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 1:6155 NW 186TH ST APT 105
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-6079
Mailing Address - Country:US
Mailing Address - Phone:786-663-3853
Mailing Address - Fax:
Practice Address - Street 1:8230 NW 178TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3652
Practice Address - Country:US
Practice Address - Phone:786-663-3853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-254586106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician