Provider Demographics
NPI:1336881846
Name:GAYOSO, JUDY MARIA
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:MARIA
Last Name:GAYOSO
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 1:15064 SW 35TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4925
Mailing Address - Country:US
Mailing Address - Phone:305-219-5728
Mailing Address - Fax:
Practice Address - Street 1:15064 SW 35TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-4925
Practice Address - Country:US
Practice Address - Phone:305-219-5728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst