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General NPI Number Information
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NPI Number | 1548733256
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Entity Type | Individual
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Provider Name | ANGI DESSIREE GOMEZ BCABA
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Gender | Female
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Dates
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Enumeration Date | 01/04/2019
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 14381 SW 268TH ST APT 208
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City | HOMESTEAD
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State | FL
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Zip | 33032-8191
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Country | US
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Telephone | 786-334-3375
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Fax |
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Provider Business Mailing Address
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Address Line | 2679 SE 13TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33035-2539
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Country | US
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Telephone | 786-334-3375
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-2111782
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License Number State | FL
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