Provider Demographics
NPI:1932726965
Name:GONZALEZ BEHAVIOR ANALYSIS CORP
Entity Type:Organization
Organization Name:GONZALEZ BEHAVIOR ANALYSIS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-746-4002
Mailing Address - Street 1:5350 NW 168TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-4071
Mailing Address - Country:US
Mailing Address - Phone:270-746-4002
Mailing Address - Fax:
Practice Address - Street 1:5350 NW 168TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-4071
Practice Address - Country:US
Practice Address - Phone:270-746-4002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-25
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty