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General NPI Number Information
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NPI Number | 1952988875
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Entity Type | Individual
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Provider Name | MAIDY CARENIA BARRERA GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 6801 LAKE WORTH RD STE 115
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City | GREENACRES
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State | FL
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Zip | 33467-2965
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Country | US
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Telephone | 561-283-7181
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Fax | 561-909-0863
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Provider Business Mailing Address
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Address Line | 15125 SW 305TH TER
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City | HOMESTEAD
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State | FL
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Zip | 33033-4427
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Country | US
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Telephone | 786-499-3930
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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 | 0-22-13857
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 20-117958
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-23-66201
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License Number State | FL
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