Healthcare Provider Details

I. General information

NPI: 1003698572
Provider Name (Legal Business Name): DARIEL CID GONZALEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8231 NW 7TH ST
MIAMI FL
33126-3985
US

IV. Provider business mailing address

8231 NW 7TH ST
MIAMI FL
33126-3985
US

V. Phone/Fax

Practice location:
  • Phone: 786-804-8230
  • Fax:
Mailing address:
  • Phone: 786-804-8230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-301591
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-81201
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: