Healthcare Provider Details

I. General information

NPI: 1033342381
Provider Name (Legal Business Name): ANGELA M. GONZALEZ INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 E 45TH ST
HIALEAH FL
33013-1920
US

IV. Provider business mailing address

510 E 45TH ST
HIALEAH FL
33013-1920
US

V. Phone/Fax

Practice location:
  • Phone: 305-733-5918
  • Fax: 305-882-8119
Mailing address:
  • Phone: 305-733-5918
  • Fax: 305-882-8119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ANGELA MARIA GONZALEZ
Title or Position: OWNER/BEHAVIOR ANALYST
Credential: BCBA
Phone: 305-733-5918