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General NPI Number Information
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NPI Number | 1992445043
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Entity Type | Individual
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Provider Name | YANETSI GONZALEZ SUAREZ BCBA
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Gender | Female
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Dates
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Enumeration Date | 03/29/2022
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Last Update Date | 03/29/2022
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Provider Practice Location Address
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Address Line | 1916 NW 84TH AVE
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City | DORAL
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State | FL
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Zip | 33126-1030
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Country | US
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Telephone | 305-224-1929
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Fax | 786-441-2169
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Provider Business Mailing Address
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Address Line | 4300 SW 67TH AVE APT 34
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City | MIAMI
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State | FL
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Zip | 33155-4729
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Country | US
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Telephone | 786-209-5571
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-21-56126
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License Number State | FL
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