Provider Demographics
NPI:1538953856
Name:GONZALEZ, ANGELICA KARINA (RBT)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:KARINA
Last Name:GONZALEZ
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20300 FRANJO RD
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1821
Mailing Address - Country:US
Mailing Address - Phone:786-205-4963
Mailing Address - Fax:
Practice Address - Street 1:20300 FRANJO RD
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1821
Practice Address - Country:US
Practice Address - Phone:786-205-4963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician