Healthcare Provider Details

I. General information

NPI: 1477900314
Provider Name (Legal Business Name): SAYLY GONZALEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2016
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13195 SW 134TH ST STE 201
MIAMI FL
33186-4585
US

IV. Provider business mailing address

8785 SW 165TH AVE STE 103
MIAMI FL
33193-5827
US

V. Phone/Fax

Practice location:
  • Phone: 786-206-6500
  • Fax:
Mailing address:
  • Phone: 786-206-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW12880
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberSW12880
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: