Provider Demographics
NPI:1205636545
Name:GONZALEZ DELGADO, YANIZ BEATRIZ
Entity type:Individual
Prefix:
First Name:YANIZ
Middle Name:BEATRIZ
Last Name:GONZALEZ DELGADO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1172 NW 134TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-2279
Mailing Address - Country:US
Mailing Address - Phone:786-516-9981
Mailing Address - Fax:
Practice Address - Street 1:3508 NW 114TH AVE UNIT 108
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-1841
Practice Address - Country:US
Practice Address - Phone:786-426-2023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24395521106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician