Provider Demographics
NPI:1790423820
Name:GONZALEZ ALVAREZ, RODNEY
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:
Last Name:GONZALEZ ALVAREZ
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 1:19261 STERLING DR
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7720
Mailing Address - Country:US
Mailing Address - Phone:786-817-9586
Mailing Address - Fax:
Practice Address - Street 1:19261 STERLING DR
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7720
Practice Address - Country:US
Practice Address - Phone:786-817-9586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician