Healthcare Provider Details

I. General information

NPI: 1639085053
Provider Name (Legal Business Name): ARMANDO DAVID GONZALEZ MARTINEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 W 76TH ST UNIT 1
HIALEAH FL
33016-1834
US

IV. Provider business mailing address

8316 N CORAL CIR
NORTH LAUDERDALE FL
33068-4114
US

V. Phone/Fax

Practice location:
  • Phone: 786-391-4030
  • Fax:
Mailing address:
  • Phone: 786-620-5750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2832084
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: