Provider Demographics
NPI:1154946945
Name:GONZALEZ IZQUIERDO, CLAUDIA (RBT)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:GONZALEZ IZQUIERDO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18501 NW 56TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-5328
Mailing Address - Country:US
Mailing Address - Phone:786-589-0375
Mailing Address - Fax:
Practice Address - Street 1:18501 NW 56TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-5328
Practice Address - Country:US
Practice Address - Phone:786-589-0375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-122164106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician