Healthcare Provider Details

I. General information

NPI: 1114842812
Provider Name (Legal Business Name): NADIA GONZALEZ BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

474 SE 1ST ST
HIALEAH FL
33010-5304
US

IV. Provider business mailing address

474 SE 1ST ST
HIALEAH FL
33010-5304
US

V. Phone/Fax

Practice location:
  • Phone: 786-663-8679
  • Fax:
Mailing address:
  • Phone: 786-663-8679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2836282
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: