Healthcare Provider Details

I. General information

NPI: 1346006939
Provider Name (Legal Business Name): LIANNE GONZALEZ JIMENEZ BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7830 W 8TH AVE
HIALEAH FL
33014-4013
US

IV. Provider business mailing address

13000 NW 22ND AVE
MIAMI FL
33167-1935
US

V. Phone/Fax

Practice location:
  • Phone: 786-402-1570
  • Fax:
Mailing address:
  • Phone: 786-402-1570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-91048
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-328084
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: