Provider Demographics
NPI:1881476190
Name:GONZALEZ RODRIGUEZ, AMARILYS
Entity type:Individual
Prefix:MRS
First Name:AMARILYS
Middle Name:
Last Name:GONZALEZ RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10281 SW 20TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7419
Mailing Address - Country:US
Mailing Address - Phone:786-468-1401
Mailing Address - Fax:
Practice Address - Street 1:10281 SW 20TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7419
Practice Address - Country:US
Practice Address - Phone:786-468-1401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician