MEDICARE: DANIELLA OROZCO 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	11834341	FL
2	103K00000X	Behavior Analyst
3	103K00000X	Behavior Analyst		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962878355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLA OROZCO GONZALEZ

Provider Business Mailing Address
First Line	:	16351 SW 2ND DR
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33027-1052
Country	:	US
Telephone Number	:	754-204-5669
Fax Number	:

Provider Business Practice Location Address
First Line	:	16201 NE 13TH AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4607
Country	:	US
Telephone Number	:	786-955-6224
Fax Number	:

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

Provider Enumeration Date	:	08/19/2015
Last Update Date	:	05/02/2024

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