MEDICARE: GIANA GONZALEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst		FL

General Provider Information

NPI Number	:	1205678828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIANA GONZALEZ

Provider Business Mailing Address
First Line	:	6617 DAHLIA DR
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-4910
Country	:	US
Telephone Number	:	786-447-8105
Fax Number	:

Provider Business Practice Location Address
First Line	:	2647 HOLLYWOOD BLVD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-4840
Country	:	US
Telephone Number	:	786-458-9535
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2024
Last Update Date	:	04/09/2026

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