Healthcare Provider Details

I. General information

NPI: 1295291037
Provider Name (Legal Business Name): MRS. ANNADOLYS LINARES GONZALEZ I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2019
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2453 NW 9TH ST
CAPE CORAL FL
33993-5710
US

IV. Provider business mailing address

2453 NW 9TH ST
CAPE CORAL FL
33993-5710
US

V. Phone/Fax

Practice location:
  • Phone: 239-878-8290
  • Fax:
Mailing address:
  • Phone: 239-878-8290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-19-75146
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-25-15956
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: