Provider Demographics
NPI:1003602095
Name:SILVERIO GONZALEZ, INDRA (BS, RBT)
Entity type:Individual
Prefix:
First Name:INDRA
Middle Name:
Last Name:SILVERIO GONZALEZ
Suffix:
Gender:
Credentials:BS, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19120 NW 51ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-2043
Mailing Address - Country:US
Mailing Address - Phone:954-991-0805
Mailing Address - Fax:
Practice Address - Street 1:19120 NW 51ST AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-2043
Practice Address - Country:US
Practice Address - Phone:954-991-0805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-428294106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician