Healthcare Provider Details

I. General information

NPI: 1427627231
Provider Name (Legal Business Name): ANA LUISA GONZALEZ RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 NW 4TH ST APT 708
MIAMI FL
33128-1703
US

IV. Provider business mailing address

445 NW 4TH ST APT 708
MIAMI FL
33128-1703
US

V. Phone/Fax

Practice location:
  • Phone: 786-725-7464
  • Fax:
Mailing address:
  • Phone: 786-725-7464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA24210
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-139262
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: