Provider Demographics
NPI:1205522851
Name:GONZALEZ, LUIS FRANCISCO (RBT-23-269222)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:FRANCISCO
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:RBT-23-269222
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8911 SW 123RD CT APT 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4104
Mailing Address - Country:US
Mailing Address - Phone:786-205-1821
Mailing Address - Fax:
Practice Address - Street 1:8911 SW 123RD CT APT 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4104
Practice Address - Country:US
Practice Address - Phone:786-205-1821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-17
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-269222106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician