Provider Demographics
NPI:1215525878
Name:GONZALEZ, YANIRIS (CBHCM)
Entity type:Individual
Prefix:
First Name:YANIRIS
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:CBHCM
Other - Prefix:
Other - First Name:YANIRIS
Other - Middle Name:
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CBHCM
Mailing Address - Street 1:2531 GULFSTREAM RD
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33406-8552
Mailing Address - Country:US
Mailing Address - Phone:561-906-4181
Mailing Address - Fax:
Practice Address - Street 1:800 W OAKLAND PARK BLVD STE 213
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33311-1733
Practice Address - Country:US
Practice Address - Phone:954-982-2814
Practice Address - Fax:954-982-2824
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator