Provider Demographics
NPI:1821699711
Name:GONZALEZ FORTE, ARIADNA
Entity Type:Individual
Prefix:
First Name:ARIADNA
Middle Name:
Last Name:GONZALEZ FORTE
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 1:740 BENEVENTO AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2013
Mailing Address - Country:US
Mailing Address - Phone:786-641-2900
Mailing Address - Fax:
Practice Address - Street 1:740 BENEVENTO AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2013
Practice Address - Country:US
Practice Address - Phone:786-641-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-23-66740103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst