Provider Demographics
NPI:1013708460
Name:FUENTES GONZALEZ, OSLEIDY DE LA CARIDAD
Entity type:Individual
Prefix:
First Name:OSLEIDY
Middle Name:DE LA CARIDAD
Last Name:FUENTES 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 1:1635 W 44TH PL APT 314
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7463
Mailing Address - Country:US
Mailing Address - Phone:305-746-9306
Mailing Address - Fax:
Practice Address - Street 1:1635 W 44TH PL APT 314
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7463
Practice Address - Country:US
Practice Address - Phone:786-817-8146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst