Provider Demographics
NPI:1811427362
Name:GONZALEZ TORRES, DANISLEIDYS
Entity type:Individual
Prefix:
First Name:DANISLEIDYS
Middle Name:
Last Name:GONZALEZ TORRES
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 1:4521 NW 95TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5161
Mailing Address - Country:US
Mailing Address - Phone:786-328-6440
Mailing Address - Fax:
Practice Address - Street 1:3035 NW 26TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-6417
Practice Address - Country:US
Practice Address - Phone:786-328-6440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician