MEDICARE: ADALIGIA 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	103K00000X	Behavior Analyst	1-25-85703	FL

General Provider Information

NPI Number	:	1679437297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADALIGIA GONZALEZ

Provider Business Mailing Address
First Line	:	5020 NW 190TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-2446
Country	:	US
Telephone Number	:	305-962-7350
Fax Number	:

Provider Business Practice Location Address
First Line	:	5020 NW 190TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-2446
Country	:	US
Telephone Number	:	305-962-7350
Fax Number	:

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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