Madeleyne Crespo Gonzalez, RBT
Individual provider Active NPI Behavior Technician · Redland, FL
NPI 1164047601 · NPPES record last updated Jun 10, 2020
Key facts
- NPI
- 1164047601
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-20-118807 (FL)
- Practice address
- 26400 SW 182ND Ave
Redland, FL 33031-2202 - Phone
- (305) 316-3430
- NPI assigned
- Jun 10, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-118807 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Little Blue Bees Behavior Therapy Services Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-20-118807 | FL | Yes |
Addresses
Primary practice location
26400 SW 182ND Ave
Redland, FL 33031-2202
Mailing address
26400 SW 182ND Ave
Redland, FL 33031-2202
Phone (305) 316-3430
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.