Healthcare Provider Details

I. General information

NPI: 1700536588
Provider Name (Legal Business Name): CAMILA GONZALEZ RBT-20-147021
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 EVERGLADES BLVD N
NAPLES FL
34120-2823
US

IV. Provider business mailing address

3210 EVERGLADES BLVD N
NAPLES FL
34120-2823
US

V. Phone/Fax

Practice location:
  • Phone: 786-318-6688
  • Fax:
Mailing address:
  • Phone: 786-318-6688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-147021
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: