Provider Demographics
NPI:1912735960
Name:GONZALEZ, YAIMI (CBHCMS)
Entity type:Individual
Prefix:
First Name:YAIMI
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:
Credentials:CBHCMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18255 NW 68TH AVE APT 121
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3483
Mailing Address - Country:US
Mailing Address - Phone:305-753-6461
Mailing Address - Fax:305-437-8159
Practice Address - Street 1:15305 NW 60TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2461
Practice Address - Country:US
Practice Address - Phone:786-536-7561
Practice Address - Fax:305-437-8180
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCMS.0102734171M00000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator