Provider Demographics
NPI:1972398659
Name:LLOPIZ GONZALEZ, GEMA LUSIMEY
Entity type:Individual
Prefix:
First Name:GEMA
Middle Name:LUSIMEY
Last Name:LLOPIZ GONZALEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 NW 47TH CT
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-4054
Mailing Address - Country:US
Mailing Address - Phone:786-343-5700
Mailing Address - Fax:
Practice Address - Street 1:465 NW 47TH CT
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-4054
Practice Address - Country:US
Practice Address - Phone:786-343-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB1009276106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician