Provider Demographics
NPI:1396255048
Name:GONZALEZ-RUBIO, KARLA CECILIA
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:CECILIA
Last Name:GONZALEZ-RUBIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 CATALONIA AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6727
Mailing Address - Country:US
Mailing Address - Phone:305-586-5217
Mailing Address - Fax:
Practice Address - Street 1:3655 CORTEZ RD W STE 140
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3147
Practice Address - Country:US
Practice Address - Phone:941-888-2081
Practice Address - Fax:888-700-6760
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-09
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW110261041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical