Healthcare Provider Details

I. General information

NPI: 1730968009
Provider Name (Legal Business Name): DENISE DE LOS ANGELES GELPI DEL SOL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 09/26/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9070 SW 125TH AVE APT 204
MIAMI FL
33186-7129
US

IV. Provider business mailing address

9070 SW 125TH AVE APT 204
MIAMI FL
33186-7129
US

V. Phone/Fax

Practice location:
  • Phone: 786-942-8588
  • Fax:
Mailing address:
  • Phone: 786-942-8588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-276898
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: