Provider Demographics
NPI:1154157584
Name:GONZALEZ RODRIGUEZ, MELISSA (RBT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:GONZALEZ RODRIGUEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:420 E 8TH ST APT 1047
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4560
Mailing Address - Country:US
Mailing Address - Phone:786-651-1528
Mailing Address - Fax:561-828-3124
Practice Address - Street 1:8300 NW 53RD ST STE 350
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-7712
Practice Address - Country:US
Practice Address - Phone:305-776-0728
Practice Address - Fax:561-828-3124
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician