MEDICARE: BERLIS RODRIGUEZ 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
1	106S00000X	Behavior Technician	RBT-25-502490	FL

General Provider Information

NPI Number	:	1922963909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERLIS RODRIGUEZ GONZALEZ RBT

Provider Business Mailing Address
First Line	:	3220 N HAVERHILL RD APT B106
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-2988
Country	:	US
Telephone Number	:	561-537-9819
Fax Number	:

Provider Business Practice Location Address
First Line	:	3220 N HAVERHILL RD APT B106
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-2988
Country	:	US
Telephone Number	:	561-537-9819
Fax Number	:

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

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

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