Provider Demographics
NPI:1376065649
Name:GAMEZ, ELIA MARIA
Entity type:Individual
Prefix:
First Name:ELIA
Middle Name:MARIA
Last Name:GAMEZ
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 1:16519 SW 36TH STREET
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027
Mailing Address - Country:US
Mailing Address - Phone:305-522-0832
Mailing Address - Fax:
Practice Address - Street 1:16519 SW 36TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4521
Practice Address - Country:US
Practice Address - Phone:305-522-0832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLG520-213-62-861-0106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician