Provider Demographics
NPI:1942802673
Name:GONZALEZ AGUADO, DILEY DE LA CARIDAD
Entity Type:Individual
Prefix:
First Name:DILEY
Middle Name:DE LA CARIDAD
Last Name:GONZALEZ AGUADO
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 1:231 E 58TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1245
Mailing Address - Country:US
Mailing Address - Phone:786-716-3754
Mailing Address - Fax:
Practice Address - Street 1:231 E 58TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1245
Practice Address - Country:US
Practice Address - Phone:786-716-3754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT20143536106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician