Provider Demographics
NPI:1932423274
Name:GOMEZ BEHAVIOR SERVICES, INC.
Entity Type:Organization
Organization Name:GOMEZ BEHAVIOR SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:C
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:305-662-6448
Mailing Address - Street 1:9415 SW 72ND ST
Mailing Address - Street 2:SUITE 131
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5427
Mailing Address - Country:US
Mailing Address - Phone:305-662-6448
Mailing Address - Fax:
Practice Address - Street 1:9415 SW 72ND ST
Practice Address - Street 2:SUITE 131
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5427
Practice Address - Country:US
Practice Address - Phone:305-662-6448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-04-1676252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency