MEDICARE: NAIBELY CORONA 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
1	106S00000X	Behavior Technician	RBT-24-347324	FL

General Provider Information

NPI Number	:	1891529483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAIBELY CORONA GONZALEZ

Provider Business Mailing Address
First Line	:	8271 NW 177TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-3642
Country	:	US
Telephone Number	:	786-849-4378
Fax Number	:

Provider Business Practice Location Address
First Line	:	7900 NW 155TH ST STE 204
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5844
Country	:	US
Telephone Number	:	786-536-2077
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2024
Last Update Date	:	03/18/2025

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Directions to “ NAIBELY CORONA GONZALEZ ” Practice Location

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