Provider Demographics
NPI:1336900133
Name:GONZALEZ PEREZ, DANIELA DE LA CARIDAD
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:DE LA CARIDAD
Last Name:GONZALEZ PEREZ
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 1:8000 SW 149TH AVE APT A304
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1457
Mailing Address - Country:US
Mailing Address - Phone:786-731-9598
Mailing Address - Fax:
Practice Address - Street 1:8000 SW 149TH AVE APT A304
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-1457
Practice Address - Country:US
Practice Address - Phone:786-731-9598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23-317211106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician