Provider Demographics
NPI:1134090251
Name:GONZALEZ DAVILA, WALNER JOSUE
Entity type:Individual
Prefix:
First Name:WALNER
Middle Name:JOSUE
Last Name:GONZALEZ DAVILA
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 1:15529 MIAMI LAKEWAY N APT 206
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5583
Mailing Address - Country:US
Mailing Address - Phone:786-683-2778
Mailing Address - Fax:
Practice Address - Street 1:15529 MIAMI LAKEWAY N APT 206
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-5583
Practice Address - Country:US
Practice Address - Phone:786-683-2778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician