Healthcare Provider Details

I. General information

NPI: 1194322016
Provider Name (Legal Business Name): ANILEIDY GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2020
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14430 SW 180TH ST
MIAMI FL
33177-2638
US

IV. Provider business mailing address

14430 SW 180TH ST
MIAMI FL
33177-2638
US

V. Phone/Fax

Practice location:
  • Phone: 786-901-2344
  • Fax:
Mailing address:
  • Phone: 786-901-2344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: