Provider Demographics
NPI:1962214155
Name:ALMEIDA GONZALEZ, FERNANDO D
Entity type:Individual
Prefix:
First Name:FERNANDO
Middle Name:D
Last Name:ALMEIDA GONZALEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16045 NW 64TH AVE APT 314
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-7511
Mailing Address - Country:US
Mailing Address - Phone:786-424-6913
Mailing Address - Fax:
Practice Address - Street 1:16045 NW 64TH AVE APT 314
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-7511
Practice Address - Country:US
Practice Address - Phone:786-424-6913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-407220106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL125478000Medicaid