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NPI Code Detail

MEDICARE: LEYANIS GONZALEZ

MEDICARE: LEYANIS GONZALEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588287890
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEYANIS GONZALEZ
Provider Business Mailing Address
First Line : 10200 NICARAGUA DR
Second Line :
City : CUTLER BAY
State : FL
Zip : 33189-2341
Country : US
Telephone Number : 786-302-2166
Fax Number :
Provider Business Practice Location Address
First Line : 10200 NICARAGUA DR
Second Line :
City : CUTLER BAY
State : FL
Zip : 33189-2341
Country : US
Telephone Number : 786-302-2166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2020
Last Update Date : 05/20/2020

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Directions to “ LEYANIS GONZALEZ ” Practice Location

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