Provider Demographics
NPI:1780240069
Name:CEJAS GONZALEZ, AMISEL (BCBA)
Entity type:Individual
Prefix:
First Name:AMISEL
Middle Name:
Last Name:CEJAS GONZALEZ
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15522 SW 95TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1108
Mailing Address - Country:US
Mailing Address - Phone:786-757-8978
Mailing Address - Fax:
Practice Address - Street 1:15522 SW 95TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1108
Practice Address - Country:US
Practice Address - Phone:786-757-8978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-13
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB12365698103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst