Healthcare Provider Details

I. General information

NPI: 1114816956
Provider Name (Legal Business Name): LINDOMIRA HILDA RIOS DE LA GALA SR.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 GOODLETTE RD
NAPLES FL
34102-5614
US

IV. Provider business mailing address

6509 ESTERO BAY DR
FORT MYERS FL
33908-5537
US

V. Phone/Fax

Practice location:
  • Phone: 239-316-7656
  • Fax:
Mailing address:
  • Phone: 239-961-8567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: