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NPI Code Detail

MEDICARE: MAYLIN GONZALEZ M.S

MEDICARE: MAYLIN GONZALEZ M.S
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
1101YM0800XMental Health CounselorMH17371FL
2101YM0800XMental Health Counselor16392FL
3222Q00000XDevelopmental Therapist
4252Y00000XEarly Intervention Provider Agency

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 : 1609390426
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYLIN GONZALEZ M.S
Provider Business Mailing Address
First Line : 330 W 46TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33012-3947
Country : US
Telephone Number : 786-365-6235
Fax Number :
Provider Business Practice Location Address
First Line : 9900 STIRLING RD STE 103
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33024-8073
Country : US
Telephone Number : 954-300-2921
Fax Number : 954-529-2001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2017
Last Update Date : 01/24/2024

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