Healthcare Provider Details

I. General information

NPI: 1275441677
Provider Name (Legal Business Name): LIANET GONZALEZ COBAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3595 NW 191ST ST
MIAMI GARDENS FL
33056-2937
US

IV. Provider business mailing address

3595 NW 191ST ST
MIAMI GARDENS FL
33056-2937
US

V. Phone/Fax

Practice location:
  • Phone: 786-792-4659
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2843533
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: