Healthcare Provider Details

I. General information

NPI: 1982367488
Provider Name (Legal Business Name): ALEX NAPOLEON GONZALES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 SE OCEAN BLVD STE 130D
STUART FL
34994-3503
US

IV. Provider business mailing address

2705 RHODE ISLAND AVE
FORT PIERCE FL
34947-4775
US

V. Phone/Fax

Practice location:
  • Phone: 772-219-7575
  • Fax: 855-457-4263
Mailing address:
  • Phone: 772-475-0641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-24-15670
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: