Provider Demographics
NPI:1033726393
Name:GONZALEZ MENDEZ, OSCAR
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:GONZALEZ MENDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 EVERGLADES BLVD N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-5547
Mailing Address - Country:US
Mailing Address - Phone:305-302-4749
Mailing Address - Fax:
Practice Address - Street 1:1921 EVERGLADES BLVD N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-5547
Practice Address - Country:US
Practice Address - Phone:305-302-4749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-131841106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108465500Medicaid