Provider Demographics
NPI:1144078155
Name:VEIRA GONZALEZ, SOLMAR
Entity type:Individual
Prefix:
First Name:SOLMAR
Middle Name:
Last Name:VEIRA GONZALEZ
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 1:2760 W 76TH ST APT 207
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5758
Mailing Address - Country:US
Mailing Address - Phone:786-303-0840
Mailing Address - Fax:
Practice Address - Street 1:2760 W 76TH ST APT 207
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5758
Practice Address - Country:US
Practice Address - Phone:786-303-0840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-340201106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician