Healthcare Provider Details

I. General information

NPI: 1902761901
Provider Name (Legal Business Name): YANDRO GONZALEZ RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13195 SW 134TH ST
MIAMI FL
33186-4499
US

IV. Provider business mailing address

13195 SW 134TH ST
MIAMI FL
33186-4499
US

V. Phone/Fax

Practice location:
  • Phone: 786-227-6830
  • Fax: 786-524-2413
Mailing address:
  • Phone: 786-227-6830
  • Fax: 786-524-2413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-499996
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: