Provider Demographics
NPI:1568299030
Name:CALZADO GOMEZ, YULIZA (RBT)
Entity type:Individual
Prefix:
First Name:YULIZA
Middle Name:
Last Name:CALZADO GOMEZ
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 1:117 SW 10TH ST APT 1401
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-3685
Mailing Address - Country:US
Mailing Address - Phone:786-747-8952
Mailing Address - Fax:
Practice Address - Street 1:117 SW 10TH ST APT 1401
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3685
Practice Address - Country:US
Practice Address - Phone:786-747-8952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-266021106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty