Healthcare Provider Details

I. General information

NPI: 1346882396
Provider Name (Legal Business Name): KARINA CRUZ GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7440 N KENDALL DR
MIAMI FL
33156-7751
US

IV. Provider business mailing address

3951 SW 129TH AVE
MIAMI FL
33175-3311
US

V. Phone/Fax

Practice location:
  • Phone: 305-965-9074
  • Fax:
Mailing address:
  • Phone: 305-965-9074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number02617067
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: