Provider Demographics
NPI:1073321949
Name:TOLEDO GONZALEZ, MILENA (RBT)
Entity type:Individual
Prefix:
First Name:MILENA
Middle Name:
Last Name:TOLEDO GONZALEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:MILENA
Other - Middle Name:
Other - Last Name:TOLEDO GONZALEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:9707 WEEPING CHERRY CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-1088
Mailing Address - Country:US
Mailing Address - Phone:813-859-9499
Mailing Address - Fax:
Practice Address - Street 1:9707 WEEPING CHERRY CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-1088
Practice Address - Country:US
Practice Address - Phone:813-859-9499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-24
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24-398662106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician