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NPI Code Detail

MEDICARE: THALIA GONZALEZ RBT

MEDICARE: THALIA GONZALEZ RBT
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
1106S00000XBehavior TechnicianRBT-24-366635FL

General Provider Information

NPI Number : 1881424521
Entity Type Code : Individual
Provider Name (Legal Business Name) : THALIA GONZALEZ RBT
Provider Business Mailing Address
First Line : 1910 DAMON AVE
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-2909
Country : US
Telephone Number : 786-674-2389
Fax Number :
Provider Business Practice Location Address
First Line : 6900 S ORANGE BLOSSOM TRL STE 400
Second Line :
City : ORLANDO
State : FL
Zip : 32809-5734
Country : US
Telephone Number : 786-674-2389
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2024
Last Update Date : 01/05/2026

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Directions to “ THALIA GONZALEZ RBT” Practice Location

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