Healthcare Provider Details

I. General information

NPI: 1750279436
Provider Name (Legal Business Name): ALAIN LLANO GONZALEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 NICHOLAS PKWY W
CAPE CORAL FL
33991-5501
US

IV. Provider business mailing address

1005 NICHOLAS PKWY W
CAPE CORAL FL
33991-5501
US

V. Phone/Fax

Practice location:
  • Phone: 786-918-9602
  • Fax:
Mailing address:
  • Phone: 786-918-9602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-393737
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: